NATIONAL  POWERBOAT  ASSOCIATION

Old Saybrook 2010 Between the Bridges Powerboat Poker Run   Entry Form

Print this form, fill it out and send it with check to:
N.P.B.A., 30 Morgan Ave., Greenwich, CT 06831           Tel/Fax: (203) 532-1312

Name

Street Address

City, State Zip

Phone

Fax

Age

(You MUST be 18+ years old) Email:__________________________________

How did you find out about the event ?_____________________________________________

Make of Boat

L.O.A.

Year

Name of Boat:

Color:

Registration No.

No. of Engines

Hull Material

Home Port:

Engine Make

Horsepower

Cubic Inches

Outdrive:

Exhaust System

Ratio:

Props:

Size & Pitch

Cruising Speed

Top Speed

  Event: $ 350.00          (includes 1 poker hand and dockage)

*Entry before May 1^st is $300.00       Entry After July 1 is $400.00*

$

Extra Hand ($100.00 per hand)

_____# of extra hands

$

# in CREW

Total  Enclosed

$

Insurance Co.

Policy No.

Signature:

Date:

Make Check Payable to: National Powerboat Association   30 Morgan Avenue   Greenwich, CT 06831-4940

NewVer: 05142010