Please make sure that each entrant completes his/her Entry Form.

Anacostia Port Towns Paddlesport Regatta
Entry Form

To pre-register, send signed form and entry fees by September 30th to:
Anacostia Watershed Society; 4302 Baltimore Avenue, Bladensburg, MD 20710
Contact Jim Connolly at 301.699.6204 with questions.
Pre-registration fees are $15 per person, per event. Registration is also open on race day for $20 per person, per race.

Name:                                                               Event:                                                        Event:                                                               

Event:                                                        Event:                                                         Event:                                                        

Address of Contact:                                                                                                  

City/State/Zip:                                                                                                            

Daytime Phone Number of Contact:                                                                   Club or Affiliation:                                                                                    

I know that rowing/paddling is a potentially hazardous activity. I should not enter or participate in this regatta unless I am medically able and properly trained. I agree to abide by any decision of a regatta official relative to my ability to safely complete any race. I assume all risks associated with participating in this regatta including, but not limited to, spills, contact with other participants, the effects of weather (including high heat and/or humidity, the conditions of the river and traffic on the course), all such risks being known and appreciated by me. Having read this waiver and knowing these facts, and in consideration of your acceptance of my application, I, for myself and anyone entitled to act on my behalf, waive and release the Anacostia Watershed Society, the American Canoe Association, and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver.

                                                                                                                                                     
Signature of participant (Parent of Guardian if under 18)                                 Date

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