Presented by Bud Light

PRESENTED BY BUD LIGHT Port Hu ron PowerSail and Squadron www.phpsd9.c Saturday, July 12, 2014 • 9:00pm om

1 REGISTRATION FORM

Boat Name: ______Make: Model: Length: Class: Pontoon Boat Power Boat 16’ - 29’ Power Boat over 30’ Sailboat 20’ & over How did you hear about this event? Skipper: Owner’s Name: Group Represented: ______Marina or Yacht Club affiliation: ______Years you have owned/operated a boat: ______Past Awards: ______Theme (if known): ______Other Interesting Facts about the Entry: ______

CONFIDENTIAL The following information willINFORM not be releasedATION to the media or general public.

Address: ______City: ______State: _____ Zip: ______Primary Phone: ______Alternate Phone: ______Email Address

Boat MC or Doc #:

All boats are expected to be decorated and well lit. All boats must be motorized. All skippers will be required to attend an informational safety meeting at the Port Huron Sail and Power Squadron prior to the Lighted Boat Parade. Proof of Insurance is required with application. Application and Proof of Insurance can be mailed or faxed to: Port Huron Sail and Power Squadron Lighted Boat Parade Committee, Patrick McPharlin 407 Fort Street • Port Huron, MI 48060 Phone: 810-987-5978 • Fax: 810- 985-5656 DEADLINE FOR APPLICATION ON OR BEFORE JULY 7.

WAIVER, RELEASE and INDEMNITY: In consideration of being allowed to participate in the Parade, related events and activities, I agree to release and waive any and all claims, causes of action and/or lawsuits against The Blue Water Fest, a Michigan non-profit corporation, its members, officers, directors, the State of Michigan, Port Huron Sail and Power Squadron, and all other sponsoring organizations (“Released Parties”), for any loss or damage due to bodily injury, death, property damage or any other damages sustained while participating in the Parade and related events and activities. I also agree to indemnify, defend and hold harmless the Released Parties, from and against any and all actions, claims and/or damages, including costs and attorney fees, due to personal injury, property damage or intangible damage, asserted by any third person, caused directly, in whole or in part by the conduct of Applicant, and Applicant’s agents, employees and crew, except where the negligence of the Released Parties is a contributing cause of the damage.

I also agree to conform to and to comply with all the rules and regulations governing this event as well as the directions, safety requirements, instructions and regulations of the United States Coast Guard, The Port Huron Police Dept., St Clair County Sheriff Dept., Michigan Dept. of Natural Resources, Parade Directors and the Parade Committee Safety Vessels. Signature: Date:

(REQUIRED) For office use only: Registration if assigned by the Parade Committee:______