Emerald Coast Poker Run 2023 Registration

EMERALD COAST POKER RUN 2023 
EVENT REGISTRATION FORM
Member Name
Club membership is required to participate.
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Club membership is required to participate.
Boat Name or Manufacturer
Will be used on participants list and the video.
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Will be used on participants list and the video.
Email
Please enter a valid email
Mobile Phone
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Do you have a new boat?
Click yes to update our records
Yes
No
Please choose an answer
Click yes to update our records
Hotel needed in Destin?
Emerald Grande 
Yes
No
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Emerald Grande 
Do you need dockage in Destin?
Legendary Marina will contact you directly via email to arrange dockage. 
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Legendary Marina will contact you directly via email to arrange dockage. 
Legendary Marine 
$1200 Flat Rate includes:
Thursday AM through Monday at noon program-
· Unloading from trailer and reloading at end of event
· Truck and trailer parking on site
· Unlimited in/out privileges with forklift, to place boat on work rack or inside rack
· Limited in-water transient docking (alternative to lifting boat out)
· Access to the Legendary Yacht club pool to relax
Legendary Marina will NOT allow us to sign documents on your behalf
Legendary will contact members DIRECTLY via email to arrange dockage.
Participant Registration 
Additional Crew $250/each  Includes: Event Shirt, Friday Fun Run lunch,  AJs party with buffet, Saturday Poker Run lunch,  Saturday Dinner & Awads Party
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Additional Crew $250/each  Includes: Event Shirt, Friday Fun Run lunch,  AJs party with buffet, Saturday Poker Run lunch,  Saturday Dinner & Awads Party
Event Registration 
Registration after August 19nd Shirt sizes not guaranteed 
$1,050.00 
ECPR23 Registration
$950.00 
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Additional crew -Captain & First Mate are included
Place the # of additional crew here to be charged correctly
Crew fee
$250.00 
Place the # of additional crew here to be charged correctly
Safety Management Fee
Safety Management Fee  45-60 mph GREEN 
$75.00 
Safety Management Fee 65-99mph YELLOW
$85.00 
Safety Management fee 100mph+ RED
$100.00 
I have current insurance and agree to the safety agreement.
Please send us your insurance declaration page.
I agree
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Please send us your insurance declaration page.


FPC Event Cancellation Policy 
FPC Credit will be issued in most cases.

No Refunds under any circumstances, unless we registered in error or double booked. We get charged a high percentage on all credit card transactions and on all credit card returns.

	Cancel 31 days prior to event or more – $50 cancellation fee - Full balance credit toward future FPC event, plus the fee of any shirts, decals, etc. that we did not re-sell. If we mail your shirts to you, you are also responsible for the shipping fees.
	Cancel 15-30 days prior to event or more –$100 cancellation fee. Balance will be credit toward future FPC event - plus the fee of any shirts, decals, etc. that we did not re-sell will be deducted. If we mail your shirts to you, you are also responsible for the shipping fees.
	Cancel 8-14 days or less – 50% credit and the fee of any shirts, decals, etc. that we did not re-sell will also be deducted. If we mail your shirts to you, you are also responsible for the shipping fees.
	Cancel 7 days or less – no credit issued – shirts etc. will be mailed to you.


Hotel and dockage reservations are guaranteed in advance. Cancellations policy for the individual property will prevail. Most hotels will not refund your deposit unless we at FPC can re-sell your room. 
30 Day Cut Off is a common policy with the hotels we work with.
Yes
No
FPC Credit will be issued in most cases.

No Refunds under any circumstances, unless we registered in error or double booked. We get charged a high percentage on all credit card transactions and on all credit card returns.

	Cancel 31 days prior to event or more – $50 cancellation fee - Full balance credit toward future FPC event, plus the fee of any shirts, decals, etc. that we did not re-sell. If we mail your shirts to you, you are also responsible for the shipping fees.
	Cancel 15-30 days prior to event or more –$100 cancellation fee. Balance will be credit toward future FPC event - plus the fee of any shirts, decals, etc. that we did not re-sell will be deducted. If we mail your shirts to you, you are also responsible for the shipping fees.
	Cancel 8-14 days or less – 50% credit and the fee of any shirts, decals, etc. that we did not re-sell will also be deducted. If we mail your shirts to you, you are also responsible for the shipping fees.
	Cancel 7 days or less – no credit issued – shirts etc. will be mailed to you.


Hotel and dockage reservations are guaranteed in advance. Cancellations policy for the individual property will prevail. Most hotels will not refund your deposit unless we at FPC can re-sell your room. 
30 Day Cut Off is a common policy with the hotels we work with.
FPC MEMBER/PARTICIPANT ROOM &  LODGING GUARANTEE:
Florida Powerboat Club secures premium lodging inventory through contractual obligations with hotels and resorts to enable participants to attend events, often at preferred or discounted rates. These resort properties are located in high-
demand destinations during Florida’s highest levels of tourism and visitation; therefore, room contacts require a full commitment by Florida Powerboat Club to guarantee reservations with NO CANCELLATION ALLOWANCES, other than a Force Majeure incidents which are essentially ACTS of GOD like hurricanes, pandemics or catastrophic events that prevent travel by the participant. Florida Powerboat
Club is bound to these reservation agreements and therefore members and participants must agree to be 100% fully committed to all reservations and financial obligations associated with these bookings. By sending this booking
form and requesting room inventory secured by Florida Powerboat Club, I am agreeing to be 100% financially responsible for these rooms rates, taxes and
associated fees for the rooms that I have requested. I understand that some circumstances may permit FPC staff to resell or transfer my reservation to another party, but I understand that this does not imply or guarantee that I am
released from the obligation associated with these room reservations.
Yes
No
Please choose an answer
PARTICIPANT AGREEMENT, RELEASE AND ASSUMPTION OF RISK In consideration of the Florida Powerboat Club Inc , their agents, owners, officers, volunteers, employees, and all other persons or entities acting in any capacity on their behalf (hereinafter collectively referred to as "FPCI"), I hereby agree to release, indemnify, and discharge FPCI, on behalf of myself, my spouse, my children, my parents, my heirs, assigns, personal representative, and estate as follows: 1. I acknowledge that my participation in Poker Runs and boating activities entails known and unanticipated risks that could result in physical or emotional injury, paralysis, death, or damage to myself, to property, or to third parties. I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity. The risks include, among other things: slips and falls; accidental drowning; boat capsize and entrapment; travel in remote areas; collision with objects or other watercraft; rapidly changing adverse weather and water conditions; watercraft is slippery when wet and accidents can occur getting on or off; exhaustion; exposure to the elements of the outdoors and natural surroundings which could cause cold water shock, hypothermia, hyperthermia (heat related illnesses), heat exhaustion, sunburn, dehydration; exposure to potentially dangerous wild animals, insect bites, and hazardous plant life; aggressive and/or poisonous marine life; passengers can be jolted, jarred, bounced, thrown about and otherwise shaken during rides; passengers can be thrown off the vehicles; equipment failure; accidents involving other vehicles; collision with fixed or movable objects; collisions, and flipping over; accidents or illness can occur in remote places without medical facilities; my own physical condition, and the physical exertion associated with this activity. Additionally, fatigue, chill and/or dizziness may diminish my/our reaction time and increase the risk of an accident. Furthermore, FPCI personnel have difficult jobs to perform. They seek safety, but they are not infallible. They might be unaware of a participant's fitness or abilities. They might misjudge the weather or other environmental conditions. They may give incomplete warnings or instructions, and the equipment being used might malfunction. 2. I expressly agree and promise to accept and assume all the risks existing in this activity. My participation in this activity is purely voluntary, and I elect to participate despite the risks. Additionally, I agree to wear a U.S. Coast Guard approved personal flotation device (life jacket) while participating in this activity. 3. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless FPCI from all claims, demands, or causes of action, which are in any way connected with my participation in this activity or my use of FPCI 's equipment or facilities, including any such claims which allege negligent acts or omissions of FPCI. 4. Should FPCI or anyone acting on their behalf, be required to incur attorney's fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs. 5. I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating, or else I agree to bear the costs of such injury or damage myself. I further certify that I am willing to assume the risk of any medical or physical condition I may have. 6. If I file a lawsuit against FPCI, I agree to do so solely in Florida, and I further agree that the substantive law of that state shall apply in that action without regard to the conflict of law rules of that state. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining document shall remain in full force and effect. By signing this document, I acknowledge that if anyone is hurt or property is damaged during my participation in this activity, I may be found by a court of law to have waived my right to maintain a lawsuit against FPCI based on any claim from which I have released them herein. I also agree that this document is valid for subsequent visits and participation at FPCI. I have had sufficient opportunity to read this entire document. I have read and understood it, and I agree to be bound by its terms.
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