Antique & Classic Boat Registration Form

Hydroplane and Raceboat Museum, Pacific Northwest Chapter ACBS and APBA Vintage Inboards presents-: The 7th Annual Vintage Boat and Car Show

Lake Chelan, Washington October 7 & 8, 2017 Skipper/Owner: ______First Mate: ______

ACBS MEMBERSHIP NUMBER ______(All entries must be ACBS member to participate- membership info on site) Address:______City:______State:______Zip:______Cell: ______Home Phone:______Email:______

Wooden Boat Entry (check all that apply): In-Water Display ____ Land Display ____ (call coordinator for fee) Class: Cruiser ____ Runabout ____ Utility ____ Outboard ____ Contemporary Classic ____ Boat Name: ______Manufacturer: ______Model:______Year Built: ______Length: ______Engine Make: ______Cylinders: ______H.P. ______Insurance Company and Policy Number:______

Wooden Boat Show Registration Fee: $40.00 due by September 18, 2016 to insure dock availability $______NOTE: Boat Registration after September 18, 2016 will be $50.00 Friday Night – Sept 30, Reception: $15.00/person (Details to follow) # Attending? _____ $______Saturday Night - Oct. 1, Awards Banquet: $40.00/person # Attending? _____ $______At Campbell’s Resort - No refunds on banquet due to Resort policy and scheduling Total: Make check payable to: HARM (Hydroplane & Raceboat Museum) TOTAL DUE: $ ______Questions? Call David Williams at 206-764-9453 or Email: [email protected] Mail completed form & check to: M&M, c/o HRM, 5917 S 196th St, Kent, WA 98032 More info at: www.mahoganyandmerlot.com See us on Facebook – as Mahogany Merlot I hereby waive any claim for injury to my person, boat or personal property for damage or loss that may occur due to my participation either personally or through the use of my boat, personal property or equipment in the 6th Annual Lake Chelan Mahogany & Merlot Classic Boat and Hydro Show on September 30-October 2, 2016 at the Lake Shore Marina in Chelan, Washington. I acknowledge that I am responsible for any family members, guests and/or minors that may accompany me on my vessel or within the restricted areas of the event. Further, I certify that I currently have effective insurance to cover any damage to my boat, and to cover my liability from any damages to others and their property arising from the use of my boat during this event. I agree to hold harmless the Hydroplane and Raceboat Museum, City of Chelan and all sponsors, organizers, hosts of said Show, their employees, officers, agents, and volunteer assistants for any injury or loss resulting directly and indirectly from any actions, failure to act, or omissions of said sponsors, organizers, host of said show, their employees, officers, agents, and volunteer assistants, or others having, or allegedly having, any connection with said Show. It is required that all boat show par- ticipants be current ACBS members for show insurance. Hours of Show: Saturday: 9 – 4 ONLY – Your signature indicates your acceptance of these hours of the show, and that your boat will be in attendance on Saturday (unless previous arrangements made with event coordinators) and that you will adhere to all rules and regulations of the show as required by H.A.R.M and safety officers. AGREED AND ACCEPTED: (Signatures required with payment to process registration) Signed (Skipper)______Date ______