Please print a copy of this form, fill in ALL information requested for each boat entered and mail with entry fees to:

Riverside Boat Club Regatta Committee
769 Memorial Drive
Cambridge, MA 02139

Email: peter.morelli@hanscom.af.mil
Internet: http://www.riversideboatclub.com 

Name of Regatta: __________________________________________________

Event Number: ______ Event Title: _________________________________ 

Name of Organization(s) 

Submitting Entry: _________________________________________________ 

              First Name       Last Name         Date of Birth 

Single/Bow __________________ __________________ ___ / ___ / ____ 

         2 __________________ __________________ ___ / ___ / ____ 

         3 __________________ __________________ ___ / ___ / ____ 

         4 __________________ __________________ ___ / ___ / ____ 

         5 __________________ __________________ ___ / ___ / ____ 

         6 __________________ __________________ ___ / ___ / ____ 

         7 __________________ __________________ ___ / ___ / ____ 

         8 __________________ __________________ ___ / ___ / ____ 

       Cox __________________ __________________ ___ / ___ / ____

     Sub 1 __________________ __________________ ___ / ___ / ____ 

     Sub 2 __________________ __________________ ___ / ___ / ____ 

Contact Person: ___________________________________________________ 

Phone: (_____)______-________ Email: ______________________________ 

Organization Name: ________________________________________________ 

Address: __________________________________________________________ 

City: ____________________________ State: _______ Zip _____________