Carleton Place Dragon Boat Festival

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Online Team Registration

Please provide the following contact information:

First Name

Last Name

Team Captain

Team Name

Street Address

City

State/Province

Zip/Postal Code

Phone

E-mail

Alternate Contact

Alternate E-mail

Team Information (Please make selections from both drop down menus):

Cox/Steersperson required

(Note that Community Teams must have a minimum of 15 paddlers residing in Carleton Place, Beckwith Township or Mississippi Mills)

Entries and fees received by July 09, 2010 will be entitled to one free practice session. Please send cheque or money order no later than August 20, 2010 payable to:

Carleton Place Dragon Boat Festival Committee

P.O. Box 153

Carleton Place, Ontario, K7C 3P3

by submission of this form, enter the the Carleton Place Dragon Boat Festival 2010, representing the

(Registered name of Dragon Boat team) and agree to abide by the following certification.

I certify that all competitors on my team are physically fit & trained to swim at least 50 metres wearing light clothing, I also confirm that each competitor has undergone a medical check & that there is no medical reason why he/her should not take part in the program of races notified by the organizers of the Carleton Place Dragon Boat Festival (CPDBF). I hereby expressly agree to abide by all rules & conditions of the organizers & hereby discharge the CPDBF & the Carleton Place Canoe Club, as well as any other individual or organizations connected directly or indirectly with the CPDBF, from any responsibility in the event of injury, death or loss of property incurred during, as a consequence of, or whilst traveling to/from the CPDBF. I further declare that all fees due as notified by the CPDBF Committee in respect of the crew named, will be paid in full when requested & that in the event of any debts incurred by the said team that the above named Dragon Boat team will reimburse the CBDBF Committee in full within 30 days of the end of said Festival.