Nacraxtreme Regatta - Entry Form

Entry Form

Instructions
Please complete the form below to register for your selected event below. * = required field.

Events - Select an Event, then a Division to enter
Event *
Division *
Discount off fees may apply to your series, please refer to your NOR.
Skipper
First Name *		Telephone *
Last Name *		Fax
Address 1 *		Email
Address 2		Date of Birth *
City *		Club *
State *		T-Shirt Size *
Country *		YA Number *
Postcode *		NACRA Assoc. # *
Crew
First Name *		Telephone *
Last Name *		Fax
Address 1 *		Email
Address 2		Date of Birth *
City *		Club *
State *		T-Shirt Size *
Country *		YA Number *
Postcode *		NACRA Assoc.# *
Boat Details
Sail No. *		Boat Name *
Advertising*		Sponsor/Product
Boat Type *		Current Measurement Certificate
Release and Indemnity Agreement
* I agree to be bound by The Racing Rules of Sailing (RRS) and all other rules that govern this event. I agree that none of the organizations, persons involved in the running of this event, sponsors, promoters, class association or any other involved persons or parties accepts liability for damages due in negligence or any other reason whatsoever while conducting or connected with this event for injury, to property or person, I may suffer while participating in the event and while upon the event premises. I know the risks of danger to myself and my property while preparing for and participating in the event, and while upon the event premises, relying upon my own judgment and ability, assume all such risks of loss and hereby agree to reimburse all costs to those persons or organizations connected with this event for damages incurred as a result of my negligence. I agree that skipper and crew (if applicable) comply with RRS 46 and the YA prescription and hold a valid Silver Card. An international competitor is exempt from the YA prescription but must still be a member of a club affiliated to ISAF recognised Member National Authority. Please also refer to each NOR for the series Disclaimer of Liability.
Skipper Signature	�
Crew Signature	�
* I certify that I hold third party liability insurance to a minimum value of $AUD5 million or in accordance with the Notice of Race.
Skipper Signature	�
Payment
Amount Due		Payment Method *
�	�
Credit Card Number	�
Name on Credit Card	�
Expiry Date (MM/YYYY)	�
Payments may be made by cash, cheque, money order. Discount off fees may apply to your series, please refer to your NOR.
Print		Print, Sign and have ready when you finalise your entry at the event.
		After you have printed the form please submit it.