Monday, September 26, 2016
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Pre-Registration
Ship # (*)
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Ship Name
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Council Name
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Skippers Name
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Address
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Address
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City
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State
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Zip
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Phone Number
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Skippers Email Address
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Skippers Cell Phone (*)
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Boatswains First Name
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Boatswains Last Name
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Boatswains Cell Phone (*)
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Boatwains Email
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Indicate the number of participants (estimate please - we will not hold you to this count, but it will help us plan):
Number of Youth, Male
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Number of Youth, Female
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Number of Adult, Male
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Number of Adult, Female
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Special Needs: Include gender, if an adult or youth member, and details:
Special Needs 1
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Special Needs 2
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Special Needs 3
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When do you anticipate arrival:
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