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FLORIDA POWERBOAT CLUB MIAMI BOAT SHOW POKER RUN 2014. February 20-23, 2014

Member Name: _______________________________________________________________________ Boat Name-Make: _________________________________________________ Email: ____________________________________________________

New boat? Y / N

Zip code: _____________

Cell Phone: _________________________________ Decal Color choice: _______________

Choose departure date: (Circle one)

1 (Thursday Feb. 20)

or

2 (Friday Feb. 21).

Names of Crew: Please indicate t-shirt sizes (see * below). Crew names are very important (video, etc…)

1st Mate: ___________________________________________

Captain: ________________________________________ T-shirt size: S

M

L

XL

XX

(circle one)

Crew 1: _________________________________________ T-shirt size: S

M

L

XL

XX

M

L

XL

XX

M

L

XL

XX

M

Crew 4:

Crew 6:

XL

XX

(Ladies top)

M

L

XL

XX

(Ladies top)

___________________________________________ T-shirt size: S

(Ladies top)

L

___________________________________________ T-shirt size: S

(Ladies top)

Crew 5: _________________________________________ T-shirt size: S

Crew 2:

(Ladies top)

Crew 3: _________________________________________ T-shirt size: S

T-shirt size: S

M

L

XL

XX

(Ladies Top)

___________________________________________ T-shirt size: S

M

L

XL

XX

(Ladies top)

____________________________________________________________________________________________________ o

Club Membership is necessary to participate on this event. Do you need information? Y / N

o

Insurance Policy Information- Insurance Co: __________________________________________

Agent ____________________________________ Agent Phone # ________________________________ Insurance Policy Number? Please list Policy#:_________________________________________________ Note: If we do not have a copy of your insurance, a copy must accompany this application. *Note: Late fees apply if registration is received after cutoff dates. Deadline is 30 days prior to event.

Event Fee (Captain & mate): $750………………………………………………………………………………… Extra crew: $150 _______ Includes event tee & catered function passes Additional T-shirts or Ladies tanks $20 each.……..……………………… Tee Sizes: ___S ___M ___ L ___XL ___XX - Ladies tanks: ___S ___M ___L Additional Event BluRay ($30) ……………………………………………..... Safety Management Fund:

Sponsor Dock Fee:

$ 750.00 $ ______________ $ ______________ $ ______________

____ $50 for boats running 40 – 60mph

___$100 boats 60-99mph ____$150 boats 100+ ……....

$ ______________

………………………..………………………..…..……….

$ ______________

Other Charges/credits:

………………………..………………………..…..……

$ ______________

...………….…......

$ ______________

Total Payable: Event Fees may be paid by:

!Amex ! M/C ! VISA ! Discover ! Check

Card#: ___________________________________________________________ Exp: _______________ VIN: ________ Name: _____________________________________Signature: _____________________________Date: _____________ No returns or refunds, cancellations. Credit policy applies to all prepaid event fees

PLEASE FAX A COPY OF THESE FORMS TO:

" (954) 782-2452 or email to Jackie@flpowerboat.com


FLORIDA POWERBOAT CLUB – MIAMI BOAT SHOW POKER RUN ‘13. Page 2 of 2

DOCKING AND ACCOMMODATIONS & RESERVATION FORM Member Name: ___________________________________________________

1 Thursday: -Wed Feb. 19 Captains Meeting or 2

Choose departure date:

Friday: -Thurs Feb. 20 Captains Meeting

DEPARTURE HOTEL & MARINA

Please note a 13% City & County Tax will be added to your rooms.

Biscayne Bay Marriott Number of rooms: _____ Other special room requirements? Non-Smoking / Smoking

Doubletree Grand

Date: _________________________

Number of rooms: _____

Room type: ____ Std. Room (Double) - $209/night ____ Std. Room (King) - $209/night Room type: ____ Bay view King/DBL - $239/night ____1BR Condo - $349/ ___2br condo $369

Special Needs: Return Rooms Y / N Notes: ______________________________________________ Docking Info - SeaIsle Marina - $2.50 /ft

Slip: Y / N Water: Y / N

Electric: Y / N

Special Needs: ________________________________________________________________ .

DESTINATION HOTEL & MARINA

Please note an 12.5% County Tax will be added to your City & rooms.

Postcard Inn at Holiday Isle Resort Fee $15/night Number of rooms: _______ Standard'Room'' Oceanfront'King'Lanai'' $279'' Classic'Double'Queen'' Classic'3'Bedroom'Efficiency'' $279'' Classic'King'' Oceanfront'King'Deluxe'' $279'' Classic'King'Efficiency'' Classic'2'Bedroom'Suite'w' $319'' Kitchen''$499' Classic'2'Queen'Efficiency'' $319'' Oceanfront'2'Bedroom'Deluxe'' Classic'2'Bedroom'Efficiency'' $339'' Oceanfront'King'Suite'' Oceanfront'Double'Queen'' $349'' Oceanfront'2'Bedroom'Suite'w' Oceanfront'King'' Kitchen'$629' $349'' Oceanfront'2'Queen'Lanai'' $359'' Pelican Cove No Resort Fee - Number of rooms: _______

$359'' $359'' $479'' Sold'Out''

$539'' $569'' Sold'Out''

Room type: __ ____Oceanfront Oueen $263 ______Ocean View King $263 ________Efficiencies Queen bed, Q pull-out & a Kitchen $279 ____ King Jacuzzi Suite - $365/night Non-Smoking / Smoking

Cheeca Lodge - 2 night Minimum stay - $39 per day resort fee - 2 miles away from boat slips Number of rooms: _______ Docking Info - Holiday Isle

_______ $459 Golf View

______ $759 Island View

Slip: Y / N ___ Rafting on Outside Wall at Holiday Isle $1.50/ft ____ Snake Creek Marina (1 mile away)$2.00/ft

CREDIT CARD INFO - !Amex ! M/C ! VISA ! Discover ! Check Card#: _______________________________________________ Exp: ______________ Vin: ______ Name: ____________________________ Signature: _________________________ Date: __________ No returns or refunds, cancellations. Credit policy applies to all prepaid event fee

PLEASE FAX A COPY OF THESE FORMS TO: (954) 782-2452 Visit our web site for more information www.FLPOWERBOAT.com


Miami boat show 2014(1)