Mobility Cup 2005

Get On Board!!

This form is for a MC2005 Sailing Companion.

Please read the Notice of Race in the Race Details page before starting to complete your registration.

The Competitor Form may be found here.

If you have any questions or need to update your registration once you have submitted it,
please contact the DSA-A Business Manager.

Note : This is a fairly long form. Please fill in all the fields that apply to you. Mandatory fields are marked with *.
Personal Information
First Name*
Last Name*
Address*
Address 2
City*
Province/State*
Country*
Postal Code/Zip*
email Address*
Please include your area code and or country code with all phone or fax numbers.
Home Phone*
Work Phone	ext.
Cellular Phone
Fax
Gender	Male Female
Birth Year
Preferred Language	English French
Special Needs (food, medical, physical, etc.)
Other Comments
A Release and Waiver of Liability must be executed by each competitor (or guardian) and submitted to the MC2005 Registrar in order to complete registration, no later than 10:00 Saturday August 23, 2005. To confirm that you understand this requirement, please type the words " I understand and agree with this requirement " in the box below. * (required field)
Accommodation Information
If you are from out-of-town, and you have a designated Competitor, please complete the following information to better ensure that you and your Competitor obtain the best accommodation available for both of you.
I am a local Companion and am prepared to offer a billet to an out-of-town competitor. Yes No
I will be staying at
Hotel/Motel/Other Name
Phone Number
Number of others in your party
Are you also acting as an Attendant for the Competitor? Yes No
Qualification
These qualifications are not mandatory to be a Sailing Companion, but this information would be helpful to the Organizing Committee.
Certification(s)
I am physically able to transfer sailors in and out of boats
CYA Regatta Management Experience
CYA Instructor Certification
CYA Keelboat Standard Certification(s)
CYA Powerboat Standard Certification(s)
Tell us a bit about your experience (types of boats, years sailing, etc.)
Thank You
I'd like someone to follow-up with me about...
If you have any questions or need to update your registration once you have submitted it, please e-mail Mobility Cup.