4th & 5th October TEAM ENTRY FORM - Team Racing Training Clinic, LDYC
Team Name
*
Adult Representative
*
Phone Number (Adult Representative)
*
EMAIL (Adult Representative)
*
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Team Captain
Individual Competitor Information
Full name
*
Date of birth
*
-
Day
-
Month
Year
Date
Emergency Contact Name
*
Emergency Contact Phone number
*
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Crew
Individual Competitor Information
Full name
*
Date of birth
*
-
Day
-
Month
Year
Date
Emergency Contact Name
*
Emergency Contact Phone number
*
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Helm 2
Individual Competitor Information
Full name
*
Date of birth
*
-
Day
-
Month
Year
Date
Emergency Contact Name
*
Emergency Contact Phone number
*
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Crew 2
Individual Competitor Information
Full name
*
Date of birth
*
-
Day
-
Month
Year
Date
Emergency Contact Name
*
Emergency Contact Phone number
*
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Helm 3
Individual Competitor Information
Full name
*
Date of birth
*
-
Day
-
Month
Year
Date
Emergency Name
*
Emergency Contact Phone number
*
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Crew 3
Individual Competitor Information
Full name
*
Date of birth
*
-
Day
-
Month
Year
Date
Emergency Contact Name
*
Emergency Contact Phone Number
*
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Adult Representative (Must be over 18)
Individual Competitor Information
Which are you willing to help with:
*
Shoreside
Afloat
Please indicate what previous experience you have assisting at events or any Irish Sailing Racing Officials Accreditation you may have. (If you volunteer to drive a rib, please bring your NPC Licence.)
*
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Consent Form
Captain / Helm 1
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Is this sailor a member of LDYC?
*
Yes
No
If 'No' then temporary membership of LDYC for €10 must be purchased at registration to cover October 4th and 5th. Please enter Sailors name who is applying for temporary membership.
Crew 1
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Is this sailor a member of LDYC?
Yes
No
If 'No' then temporary membership of LDYC for €10 must be purchased at registration to cover October 4th and 5th. Please enter Sailors name who is applying for temporary membership.
Helm 2
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Is this sailor a member of LDYC?
Yes
No
If 'No' then temporary membership of LDYC for €10 must be purchased at registration to cover October 4th and 5th. Please enter Sailors name who is applying for temporary membership.
Crew 2
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Is this sailor a member of LDYC?
Yes
No
If 'No' then temporary membership of LDYC for €10 must be purchased at registration to cover October 4th and 5th. Please enter Sailors name who is applying for temporary membership.
Helm 3
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of
Is this sailor a member of LDYC?
Yes
No
If 'No' then temporary membership of LDYC for €10 must be purchased at registration to cover October 4th and 5th. Please enter Sailors name who is applying for temporary membership.
Crew 3
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Is this sailor a member of an Irish Sailing affiliated Club?
Yes
No
If 'No' then temporary membership of LDYC for €10 must be purchased at registration to cover October 4th and 5th. Please enter Sailors name who is applying for temporary membership.
I confirm the I have paid the associated cost of €510 for the event and Deposit. Please find payment details at https://www.ldyc.ie/event/schools-sailing-regatta
Yes
No
The Name / Reference appearing on the receivers Bank statement is:
Submit
Should be Empty: