| Tony McCloskey | Kenneth Shaw, Jr. | Dave McCormick |
| Craig O'Brien | Bob Morro | Matt Ledwith |
| Eights - $75.00 | Fours - $55.00 | Doubles - $40.00 |
Event No. _______________ Event Title ______________________________________________
| Crew | Name | Age (Masters Events only) |
| Bow | ________________________________________ | ______________ |
| 2 | ________________________________________ | ______________ |
| 3 | ________________________________________ | ______________ |
| 4 | ________________________________________ | ______________ |
| 5 | ________________________________________ | ______________ |
| 6 | ________________________________________ | ______________ |
| 7 | ________________________________________ | ______________ |
| 8 | ________________________________________ | ______________ |
| Cox | ________________________________________ | ______________ |
______________________________ Signature
_________________________________ Date
Important: Person to whom all communications (re: this entry) should be directed:Name: ____________________________________________________________
Address: ____________________________________________________________
Phone (include area code): Work: _________________ Home: _________________
Note: Any substitutions (up to half the number of oarsmen, and the coxswain) must be reported in writing, with appropriate waivers, at least 24 hours before the race. Entry must be received on or before the announced Entry Closing Date and must be accompanied by payment of the designated Entry Fee and Signed Waivers.