Head of the

Head of the Foster City Lagoon

14th November 2004

Hosted by Peninsula Aquatic Center Junior Crew
in conjunction with the City of Foster City Office of Parks & Recreation

RACE ENTRY FORM

All entry fees must be submitted with this form postmarked by November 6th

Late paperwork will be assessed an additional 50% late fee . No phone or fax entries will be accepted.

Organization: ____________________________________________________________

Contact: _________________________________________________________________

Address: ________________________________________________________________

City: ____________________________ State: __________ Zip: __________________

Phone: Day: __________________ Eve: __________________ Fax: __________________

Email: _________________________________________________________________

Race Fees:

____     8+         @ $64 = ___________

_____     4x/4+    @ $44 = ___________

_____     2x/2–    @ $30 = ___________

_____     1x *      @ $20 = ___________

TOTAL ENCLOSED: $______________

Note: Juniors only are entitled to a 25% discount on all race fees . No race entry fee is charged for the Junior’s 1x

Make checks payable to: PENINSULA AQUATIC CENTER JUNIOR CREW

Bringing a trailer? Yes: ____ No: ____

Mail completed entries to:

Head of the Lagoon

c/o Ivo Plachy, Registrar

717 Best Court

San Carlos , CA 94070

Phone; Day: (650) 367-2874, Eve: (650) 637-1798

E-mail: ivo@californiarowing.org

Head of the Foster City Lagoon 14th November 2004

Contact Person: ____________________________________ Organization: ____________________________________________

Phone: Day: ____________________ Eve: ____________________ Page _______ of _______ duplicate this form as necessary

Entry Information	Event Abbreviation a
Masters _____	Event Number a
Open _____	Boat Designation (”A”, “B”) a
Juniors _____	Average Age (Masters) a
Athlete Name (Last name, First name)		Birth Year (Master) (Junior)	P A check under each event indicates the athletes in the crew R An enclosure around the check indicates the athlete is the stroke of the boat Pá An asterisk adjacent to the check indicates the athlete is the coxswain of the boat
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Note: Juniors only are entitled to a 25% discount on all race fees . No race entry fee is charged for the Junior’s 1x

Make checks payable to: PENINSULA AQUATIC CENTER JUNIOR CREW

Head of the Foster City Lagoon 14th November 2004

Entry Information

Event Abbreviation a

Birth Year