Name of Yacht:

Owner/Skipper:

Email:

Postal Address:

Suburb:

City/Town:

Postcode:

Phone (H):

Phone (W):

Mobile:

Class/Design:

Model:

Type of Rig:

Rig Height:

Hull/Deck Colour:

LOA:

LWL:

Weight:

Beam:

Draft:

Sail Number:

Engine Make:

HP:

Fuel Capacity:

Radio Type:

  VHF        SSB

Call Sign:

Radar: Yes / No              GPS: Yes / No

Please list any alterations or additions to sails, rig or hull which may affect your handicap.

Please note that failure to notify the committee of any changes may incur a penalty.
If in doubt please contact Mark Vickers (0412 342 043)

Choose the events you wish to compete in: -

TOWNSVILLE TO PORT HINCHINBROOK RACE (Cat. 3) – Friday 21 March

DUNGENESS TO PORT HINCHINBROOK (Cat. 6) – Friday 21 March

IMPORTANT: ALL Entries are subject to the submission of the following documents prior to the briefing: -

Note: Original documents are required to be produced at the compulsory briefing on Monday 17th March for Cruising and Dungeness boats and Thursday 20th March for boats racing from Townsville to Hinchinbrook.

1. Appropriate Safety clearance	Yes:	Comments:
2. Current racing insurance certificate (for those racing)	Policy Number:
3. Crew list and Next of Kin details	Download Crew List Form (PDF)

I wish to pay the $90 Entry Fee by: -

PayPal       Direct Deposit       Cheque      In Person

I ACCEPT THAT IT IS A CONDITION OF ACCEPTANCE OF THIS RACE NOMINATION THAT THE OWNER, SKIPPER AND CREW COMPETE AT THEIR OWN RISK AND SUBJECT TO THE SAILING INSTRUCTIONS AND HEREBY INDEMNIFY AND AGREE TO KEEP INDEMNIFIED THE ORGANISING AUTHORITY, TCYC AND ITS COMMITTEE AND SPONSORS FROM ALL CLAIMS, DEMANDS AND LIABILITIES ON ACCOUNT OF ANY AND ALL INJURIES, LOSSES AND DAMAGE TO PERSON OR PROPERTY CONCERNING IN ANY WAY WITH PARTICIPATION IN THIS EVENT.

I HEREBY AGREE TO BE BOUND BY THE RACING RULES AND SAFETY REGULATIONS OF THE I.Y.R.U. INCLUDING THE
SPECIAL SAFETY REGULATIONS PRESCRIBED BY QUEENSLAND YACHTING ASSOCIATION AND ALL OTHER RULES THAT GOVERN THIS EVENT.

Name of Owner/Skipper: Date: