Nomination Form Dinghies

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Nomination Form Dinghies

Nomination Form Dinghies

Dinghy Nomination Form 2011 - 2012 Season

Helm First Name *

Helm Last Name *

What Membership Category are you *

Junior
Senior
Other:

Address *

Address Line 1

City *

City

email

Phone Number

Mobile Phone Number

Membership Number

PRSC Membership number

Crew First Name

Crew Surname

What Membership Category is you're Crew

Junior
Senior
Other:

Address

Address Line 1

Address

Address Line 2

Phone Number

Mobile Phone

Membership Number

PRSC Membership number

Class *

Flying Fifteen
Hobie 16
Mirror
Laser
Optimist
Other:

Name Of Boat *

Sail Number *

Hull Material *

Hull Colour *

Do You Require Boat Storage in the Dinghy Shed or Hard Stand *

Price of storage for season is $112.00

Boat Shed
Hardstand for Flying Fifteen
No Storage Required
I already have a boat stored and the gate number is

Do You have Third Party Insurance for $10,000,000 *

As per PRSC Sailing Instruction 24

Yes
No Not Yet
Other:

I AGREE TO BE BOUND BY THE Racing Rules of the IYRU, the prescriptions of the AYF and YAWA as well as the sailing instructions and rules of the Princess Royal Sailing Club *

I Agree
Other:

How would you like to pay for you're Nomination Fee *

Nomination Fee for 2010 - 11 Season is $60.00

Please Invoice me
I will pay at the office
I will pay online
Other:

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Chipana Drive, Little Grove WA 6330 Ph: (08) 9844 4033 E: office@prsc.com.au

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