Entry Form

47th Mosquito Catamaran Nationals

Sat 29th Dec to Thu 3rd Jan at Mordialloc SC, VIC

Skipper:

Name:*

Email address*

Address*

Phone:*

Date of Birth:

T-shirt size:*

Sailing Club:*

Emergency contact:*

Emergency Phone:*

YA membership #:*

Crew:

Name

Phone

T-shirt size

Emergency contact

Emergency phone

YA membership #

Extra T-shirts:

Number required

Specify sizes (S,M,L or XL)

Mosquito:

Boat*

If your boat does not appear in this drop-down list please contact Tim Shepperd at tshepperd@gmail.com

Hull Colour

Heavyweight (65kg+)

Sailing mode

MkI

MkII

MkI Spinnaker

MkII Spinnaker

Insurance:

Insurance company*

Policy number*

Declaration
I agree to be bound by The Racing Rules of Sailing and by all other rules that govern this event.
I have third party insurance cover of not less than $AUD 10,000,000 for any accident and agree that the Organising Authority and all parties involved in the organisation of this event accept no liability for any loss, damage or injury which may occur to any person or property, whether ashore or afloat, as a consequence of participation in the event or otherwise.

Agreement*