Courtown Sailing Club Open Regatta 2011

Sunday 28^th July 2011

Entry Form

	Helm	Crew
Name	________________	________________
Date of Birth	________________	________________
Telephone	________________	________________

Boat Type: _______________

Boat Name: _______________

DECLARATION:

I wish to enter the above named boat in the open dinghy regatta 2011. I agree to be bound by the Racing Rules of Sailing, and all other rules that govern this event. I accept full responsibility for the management and safety of the boat noted

Above and I also accept that neither Courtown Sailing Club, its members nor its representatives shall accept any liability for material damage or personal injury or death in conjunction with or prior to, during, or after the event. I further declare that I hold a valid and current Certificate of Insurance with adequate third party cover. I also agree to carry adequate insurance for the above boat, equipment and crew with minimum third party liability of €1,300,000 or equivalent which includes cover while racing.

Helm Signature: ____________________ Date: ______________

Crew Signature: ____________________ Date: ______________

Signature of Parent or Guardian of Helm (if under 18): ______________________

Signature of Parent or Guardian of Crew (if under 18): ______________________

Please return completed entry form and fee at registration.