Skipper’s Name:

Crew’s Name(s):

Sailboat Type, Length, Color:

Sail Number:

Boat’s Name:

Any additional markings?

City, State (2 letters), Zip:

Cell or Contact Telephone Number:

E-mail address:

Event Registration
Select:

Pre Registration Fee: $35.00 LKSC Members* Pre Registration Fee: $45.00 Non-LKSC Members*

Become a Member of the
Lake Kegonsa Sailing Club
(Optional)

 Yes, I would like to join the LKSC
  $40 Household/Family
  $30 Individual

EATS and DRINKS

Additional Lunch & Party

Qty 0 1 2 3 4 5 6   Additional lunch and party (one meal pkg is included) $15.00@

EXTRAS

One souvenir T-shirt is included
with registration fee.  Size:

  Small  Medium  Large  X Large

1 Additional T-shirt: $14.00

  Small  Medium  Large  X Large

2 Additional T-shirt: $14.00

  Small  Medium  Large  X Large

3 Additional T-shirt: $14.00

  Small  Medium  Large  X Large

LKSC Burgee

 1Burgee $20.00
 2 Burgees $36.00
 3 Burgees $52

TOTAL:
Please total your amount
and enter here:

$

REQUIRED
By entering your name (Skipper’s signature) here:
  Date: 00/00/00
and checking this box: 
You agree to the terms below.

*** I/we agree to assume full responsibility for any and all injuries or damages that may occur to me/us and my/our property as a result of participation in this event.  I/we agree to release, on behalf of myself/ourselves, family, heirs, and assigns, the Lake Kegonsa Sailing Club, Inc., and its officers and members, from any and all liability for damages to loss of personal property, loss of money, sickness, injury or death which might occur.  Individuals need to resolve any liability issues amongst themselves.

Any questions? Call Alan Carlson @ (608) 516-8544 or email alan@lksc.org

After you submit your registration you will be taken to our
PayPal Payment Page.
You MUST enter the Skipper’s Name along with your credit card or PayPal information.
If you do not pay you WILL NOT be registered.

Refunds:

Before May 1, 2010: A full refund minus $14 for the T-shirt is available upon request.

After May 1: A $15 refund (along with the souvenir T-shirt) will be issued upon request.

*  One T-shirt, Continental Breakfast, Lunch and Post-Race Party (snacks & beverage) included
Brats will be available for purchase at Post-Race Party

** After the pre-registration period, the LKSC cannot guarantee availability of T-shirts.
The designer of this year’s T-shirts is Mikki Heckman.