<p> Page 1 of 2 </p><p>FLORIDA POWERBOAT CLUB WINTER POKER RUN TO KEY LARGO 2018 January 26-28</p><p>Member Name: ______</p><p>Boat Name-Make: ______New boat? Y / N</p><p>Email: ______Zip code: ______</p><p>Cell Phone: ______Decal Color choice: ______</p><p>Names of Crew: Please indicate t-shirt sizes. Crew names are very important (video, etc…)</p><p>Captain: ______1st Mate: ______</p><p>T-shirt size: S M L XL XX (circle one) T-shirt size: S M L XL XX (Ladies top) </p><p>Crew 1: ______Crew 2: ______</p><p>T-shirt size: S M L XL XX (Ladies top) T-shirt size: S M L XL XX (Ladies top) </p><p>Crew 3: ______Crew 4: ______</p><p>T-shirt size: S M L XL XX (Ladies top) T-shirt size: S M L XL XX (Ladies Top) </p><p>Crew 5: ______Crew 6: ______</p><p>T-shirt size: S M L XL XX (Ladies top) T-shirt size: S M L XL XX (Ladies top) ______</p><p>Event fees DO NOT INCLUDE accommodations or dockage. *Note: Late fees of $100 will be added for registrations received after January 5, 2018</p><p>Event Fee: (Captain & mate): $800………………………….………………………………………...$______Extra crew: ______X $175.00 Includes event tee and functions passes….…….$______Additional T-shirts or Ladies tanks $20 each .……..………………………………….…………..$______Tee Sizes: ___S ___M ___ L ___XL ___XX - Ladies tanks: ___S ___M ___L Safety Management Fund: $50 for all boats……...... $50.00 Other Charges/credits: ………………………………………………………………………………….…... $ ______Total Payable:………………………….…………$- ______</p><p>FEES PAYABLE TO: FLORIDA POWERBOAT CLUB: 1214 SW 6th St. Pompano Beach, FL 33069 Event Fees may be paid by: (Please Check One) Amex M/C VISA Discover Check Card#: ______Exp: ______CVV: ______</p><p>Name: ______Signature: ______Date: ______No returns or refunds on cancellations. Credit policy applies to all prepaid event fees</p><p>PLEASE FAX FORM TO (954) 782-2452 or email [email protected]</p><p>CONTACT FLORIDA POWERBOAT CLUB FOR MORE INFORMATION: Weekdays 10AM – 5PM  (954) 545-1414 -  Fax (954) 782-2452 - www.FLPOWERBOAT.com </p><p>FLORIDA POWERBOAT CLUB – WINTER POKER RUN 2018 Page 2 of 2 </p><p>DOCKING AND ACCOMMODATIONS - RESERVATION FORM</p><p>Member Name: ______Date: ______Note: A copy of your insurance declaration page must accompany this registration. _</p><p>Club Membership is necessary to participate on this event. Do you need membership information? Y / N</p><p>Please note 13% City & County Tax and 22% resort fees will be added to your DEPARTURE HOTEL & MARINA IN SUNNY ISLES rooms. </p><p>Thursday Jan 25 (Limited Rooms – Please contact FPC for these SPECIAL RATES)</p><p>Doubletree by Hilton Ocean Point Resort & Spa: Number of rooms: ______</p><p>Room type: One bedroom suites and standard studio: $299 ______King ______Double Two bedroom suites: $449 ______King ______Double</p><p>Special Needs:: ______Return Rooms: Y / N </p><p>Docking Info: Haulover Marine Center Slip: Y / N Water: Y / N Electric: Y / N</p><p>.</p><p>Please note a 12.5% Tax will be added as well as a $39 Resort Fee per room per DESTINATION HOTEL & MARINA day PLAYA LARGO RESORT & SPA Number of rooms: ______</p><p>Two story Bungalow $639 ______1 king upstairs with sleeper couch and 1 king Downstairs (can sleep 6) Single/Double Bay Front Suite $519 _____ King _____ Double Partial Bay View $439 _____ King _____ Double Resort View $ 359 _____ King _____ Double (Check Out is Sunday January 28)</p><p>Docking Info - $3.00/ft Slip: Y / N (Limited to 25 Boats in Total Registration)</p><p>CREDIT CARD INFO - Amex M/C VISA Discover Check Card#: ______Exp: ______Vin: ______No returns or refunds, cancellations.edlicy applies to all prepaid event fee PLEASE FAX FORM TO (954) 782-2452 or email [email protected]</p>