register - Paddle Battle Long Island
Transcription
register - Paddle Battle Long Island
Stand up Paddle Boards G Kayaks TEA M 2016 JULY30 L A H C E G N LE Peconic River Riverhead, NY Racing G Music G Family BBQ Bash SUP Demos G Raffle Prizes G Vendor Expo S Win a 9ft KAYAK! $10 Raffle Registration at 9-10am (Peconic Waterfront) Team Challenge Race Course Features: Win a SUP! $10 Raffle 2.5 Mile - Fun race for all skill levels! For more info visit PaddleBattleLIcc.com or call Bryan Deluca at 631.208.9200 x102 or [email protected]. 2016 JULY30 Rain or Shine (Registration 9:00-10:00am) In the event of severe weather, rescheduled Sunday 7/31 T CHA EAM LLE Peconic River Riverhead, NY NGE Gold Team Challenge Sponsorship - $5,000.00 1. Includes team registration fee for 4 paddlers 6. Four raffle tickets for prizes 2. Logo to appear on: www.PaddleBattlelicc.com landing page top banner, 7. Eight Family BBQ and Bash tickets Facebook page, our Youtube channel and Causevox page. 8. Booth space the day of event 3. 50% OFF discount coupons to the Long Island Aquarium 9. Four "Team Challenge" tee shirts (20 Coupons) Valid through 9/1/2016. 4. Rash guard with company logo to be worn by each team member 5. Logo to appear on "Team Challenge" banner Silver Team Challenge Sponsorship - $2,000.00 1. Includes team registration fee and entry for 4 paddlers 5. Logo to appear on "Team Challenge" banner 2. Logo to appear on www.PaddleBattlelicc.com and Facebook page 6. Four raffle tickets for prizes 3. 50% OFF discount coupons to the Long Island Aquarium 7. Four Family BBQ and Bash tickets (10 Coupons) Valid through 9/1/2016 8. Booth space the day of event 4. Rash guard with company logo to be worn by team members Bronze Event Sponsorship - $750.00 1. Booth Space the day of event to sell goods for corporate promotion 2. Logo to appear on www.PaddleBattlelicc.com and Facebook page 3. 50% OFF discount coupons to the Long Island Aquarium (10 Coupons) Valid through 9/1/2016 Please make check payable to: East End Tourism Alliance Mail to: 431 East Main St. Riverhead, NY 11901 4. Logo to appear on "Team Challenge" banner 5. Two family BBQ bash tickets Please visit our website www.PaddleBattlelicc.com for all team and safety guideline, race day info and frequently asked questions. All team applications must be submitted by July 21, 2016 COMPANY NAME / ADDRESS:______________________________________ ______________________________________________________ TEAM NAME:_______________________________________________ CATEGORY: RECREATIONAL CLASS KAYAK UP TO 16’ (SIT IN/SIT ON) STAND UP PADDLE BOARD 12’6” & UNDER *REQUIRED ONE SUP PER FOUR PERSON TEAM FIRST NAME:___________________ FIRST NAME:___________________ FIRST NAME:___________________ FIRST NAME:___________________ LAST NAME:____________________ LAST NAME:____________________ LAST NAME:____________________ LAST NAME:____________________ AGE: ________ SHIRT SIZE: ________ AGE: ________ SHIRT SIZE: ________ AGE: ________ SHIRT SIZE: ________ AGE: ________ SHIRT SIZE: ________ PHONE:_______________________PHONE:_______________________ PHONE:_______________________PHONE:_______________________ EMAIL: _______________________EMAIL: _______________________ EMAIL: _______________________EMAIL: _______________________ SIGNATURE: _____________________ SIGNATURE: _____________________ SIGNATURE: _____________________ SIGNATURE: _____________________ EMERGENCY CONTACT: _______________EMERGENCY CONTACT: _______________ EMERGENCY CONTACT: _______________EMERGENCY CONTACT: _______________ PHONE: _______________________PHONE: _______________________ PHONE: _______________________PHONE: _______________________ ARE YOU A VETERAN? ARE YOU A VETERAN? ARE YOU A VETERAN? ARE YOU A VETERAN? SUP OR KAYAK EQUIPMENT NEEDED SUP OR KAYAK EQUIPMENT NEEDED SUP OR KAYAK EQUIPMENT NEEDED SUP OR KAYAK EQUIPMENT NEEDED Life vests (PFD) are required on craft. All participants must wear PFD (personal floatation device) during race. Must provide your own. Release: I realize that every time I leave shore in a small boat, I am a potential drowning victim. In addition, there is the possibility of injury from many things, including unseen obstacles, weather, current, waves, insects and other boaters. Human powered water craft require physical effort which can at times, be heavy, including: lifting, pulling and possibly prolonged exertion in adverse conditions. In signing this release, I indicate my understanding of the risks involved with activities involving human powered water craft and agree to take full responsibility for my physical condition, actions and safety. NOW THEREFORE INTENDING TO BE LEGALLY BOUND, I DO WAIVE FOR myself, my heirs and assigns and for anyone else whomsoever Claiming through me, my right to sue or in any other way to attempt to hold responsible the United Way of Long Island or the EETA its officers any so-called “race organizers” or “coordinators” or any of my fellow paddlers, for any mishaps to my person or my equipment, other than that which is due to the willful and malicious action of the individual against whom I claim relief.