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51st International Fireball Australian Championships
Rivoli Bay Sailing Club ENTRY FORM
To enter the championship, please print this form, fill it in and return it by email to the address shown. To assist the organising committee in planning please enter ASAP. The completed form should be emailed as an attachment to: [email protected] Regatta fees Ordinary entry fee $350 Ends 31st of January 2017 Late entry fee $400 Ends 11:00 hours 17 February 2017 Temporary Membership $400 All inclusive, entry and Muembership
Please Note the clothing form has a closing date of the 3rd Feb 2017 printing for Shirts and Rassi’s Absolute last date for clothing 10th Feb 2017. Late entries may also be paid to the IFASA Treasurer (or IFASA committee member) at the Rivoli Bay Sailing Club up to 1100 hours on 17th February 2017. Payment of fees Payment made by bank transfer to: International Fireball Association of South Australia (IFASA) BSB 085397 Account 772240258 Please reference your sail number and surname in the transfer. Email notification of payment to [email protected]
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Boat and Sailor Details Fireball Name Sail No Skipper Address YA Number Birth; month/year Email Phone Emergency Contact Any medical conditions we should know about Rashi size (S,M,L,XL,XXL) or Peak cap Crew Address YA Number Birth; month/year Email Phone Emergency Contact Any medical conditions that we should know about Rashi size (S,M,L,XL,XXL) or Peak cap Entry Fee Payable (includes regatta entry, 2 tickets to Welcome night and 2 tickets to presentation Presentation Night, plus the choice of a Rashi or peak cap to each Competitor.
$ Early entry fee $350 Late entry fee (after 1st Feb 2017) $400
Additional tickets for Welcome Night BBQ $ Over 12 years of age $15 each Under 12 years of age $5
Additional Presentation Dinner Tickets $ Over 12 years of age $20 each Under 12 years of age $5
Additional Rashi’s ($30 each)
List sizes S, M, L, XL, XXL
Additional Peak Caps $21 each Total Remittance Payable $ Note: There is a separate additional clothing form available for sailors and Family Members
Competitor’s Declaration: I acknowledge that my yacht has current Third Party Personal and Property Liability Insurance cover of a minimum of $AUD5,000,000 (recommended
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$AUD10,000,000) or equivalent thereof in any other currency for any one accident. I agree to be bound by the Racing Rules of Sailing 2017-2020, the International Fireball Class Rules and by the Sailing Instructions. I acknowledge that under Rule 4 (Decision to Race) I am solely responsible for deciding whether or not to continue racing my yacht. I further acknowledge and agree that my participation is entirely at my own risk.
Consent for Junior Skipper/Crew (under 18 years) I Address Phone No Email Being parent/legal guardian of Consent to him/her participating in the 51st International Fireball Championships and upon the terms and conditions set out in the entry form and Notice of Race, hereby release the organisers and officers and any representatives thereof, from any claim or demand that I may have or deem myself to have on my behalf or on anyone else’s behalf arising out of this regatta. Signed Date
Signed Date
