You may register on-line at:  http://www.clwyc.org/LaserMasterMidwinters05/reginfo.php

Name  ______________________________________________

Address  ____________________________________________

City, State, Zip ______________________________________

Day Phone __________________________________________

Evening Phone_______________________________________

Club Affiliation _______________________________________

Sail Number __________________________________________

Gender (M/F)_________________________________________

Age Category:    Apprentice Master        Master       Grand Master       Great Grand Master       (circle one)

The entry Fee is $75 USD with a $10 late fee after February 10, 2005. This includes lunch each day, a regatta banquet and a regatta souvenir.

Please make checks payable to Clearwater YC - Youth Sailing and mail to:
Clearwater Yacht Club
Attn: Laser Masters
830, South Bayway Blvd
Clearwater, FL 33767