10th ANNUAL WESTERN NEW YORK FUN RUN
63 Coshway Place, Tonawanda, New York 14150
PLEASE CALL US at (716) 946-0332 for any questions regarding the event!
Owners Name: ___________________________________ Date ____/____/____
Address: ___________________________________________________________
City: __________________________________State: _______ Zip Code: ________
PHONE; Day: (___) _________ Evening: (___) ___________Cell: (___)__________
Email Address: _________________________________
Make of Boat:________________ Model: _________ Length:_______ Year: _____
Name on Boat: ________________________ Registration # _________________
Total Number Registering: _________ OSO MEMBER Name: _________________
| Captain: ___________________________ | Shirt Size: ___________ | PDF's |
| Crew: ____________________________ | Shirt Size: ___________ | |
| 2 shirts per boat (Polo style) included in fee | ||
FEES FOR BOAT AND DRIVER $125.00 (Cost includes One Shirt)
EACH ADDITIONAL PERSON: $25.00 (Includes Additional Shirt)
After June 1, 2010 late fee is $50.00
All drivers and crew must sign a waiver prior to the event!
Signature of Captain: ________________________ (TOTAL $________)
Make Checks Payable to: Western New York Fun Run
Proof of Insurance Required! This is a Coast Guard Approved Event!
This is not a race!