SA Sailing : Standard Entry Form 1 ver25-08-02r1

HUNTER KEELBOAT

NATIONAL CLASS CHAMPIONSHIPS 2003

HENLEY MIDMAR YACHT CLUB 21^{ST TO 23RD} MARCH 2003

ENTRY FORM

Account Name : Henley Midmar Yacht Club

Bank : Standard Bank

Branch & code : Howick

Account No. : 052445275

Type : Cheque

The Regatta Secretary

Henley Midmar Yacht Club

PO Box 1151, Howick. 3290

Fax : (031) 4633739

Please enter the following yacht in the above National Class Championship event :

Yacht Details

Name : ............................................... Class : ............................... Registration Number : .........................

Registration / Measurement Certificate : No : .................................. Issued by : .......................... Issue Date : .......................

(Enclose copy with Entry Form)

Have any alterations been made since the yacht was measured for registration which could affect the validity of the certificate ? | YES | NO |

Registered Owner :......................................... Yacht Club Member ............................. Class Member : ..............................

Entry Fees : I enclose the following amount in payment

Class	Received by no later than				Amount paid (R,c)
	10^th March 2003			Closing of entries at the venue
Hunter	R250.00			R350.00
Payment method Drawer’s name	cheque	acc credit	cash	Total Payment	R

Have you attached the deposit doc ?

Competitor Details

	Helm / skipper	Crew 1
Name
Yacht Club
Membership Number
Class Membership
Address
Telephone No
Facsimile No
Date of Birth (under 21)
Signature of Competitor
Signature Parent or Guardian if under 21

Competitor declaration

By our signatures above I/we declare and agree ;

that the information provided in this entry form is to the best of our knowledge correct,to be bound by the rules, requirements and documents governing the event as defined in the Notice of Race, and to compete in the event entirely at my/our own risk, accepting that none of the organisations or persons concerned in the management of the regatta will accept any liability for damages or injury suffered at any time during the period of and as a result of participation in the Regatta.