Name  ______________________________________________

Address  ____________________________________________

City, State Zip _______________________________________

Phone Number _______________________________________

Sail Number __________________________________________

Club Affiliation ________________________________________

Fleet:    Apprentice Master        Master       Grand Master       Great Grand Master                  (circle one)

The entry Fee is $65 US with a $10 late fee after February 15th, 2003. This includes lunch each day, a regatta banquet and a regatta souvenir.

Please make checks payable to Clearwater Yacht Club Youth Sailing and mail to:
Laser Master Midwinters, Clearwater Yacht Club, 830 South Bayway Blvd, Clearwater Florida 33767.