RBYC Platinum Jubilee Regatta 3rd, 4th & 5th June 2022Are you a member of the RBYC?*YesNoCLUB* BOAT CLASS (Please select from dropdown choices)*707BlazeCruiserDinghyInternational DragonMultihullNational SquibOld GafferPhantomPredicted LogRBODRCODRS EliteDINGHY CLASS PLEASE SPECIFY: SAIL NUMBER* BOAT NAME RATING (if applicable)(If applicable) Valid rating certificate to be submitted to the RBYC by midday on Thursday 2nd June 2022 OWNER* First Surname Are you under 18 years of age?*<Select>NoYesParental/In loco parentis contact name* Parental/In loco parentis contact number* Phone*Email* Helm and Crew NamesFirst NameSurnameHelm or Crew Add RemoveI will be racing on:*Please tick the appropriate box(es) RACE ENTRY FEES: £15 per day. Friday 3rd June 2022 Saturday 4th June 2022 Sunday 5th June 2022 Select AllI will be racing on:*Please tick the appropriate box(es) RACE ENTRY FEES: £10 per day. Friday 3rd June 2022 Saturday 4th June 2022 Sunday 5th June 2022 Select AllYour Regatta Entry Fee: Price: £ 0.00 Total Amount Due DECLARATIONSDECLARATION*I wish to enter the RBYC Platinum Jubilee Regatta for the dates as shown above. I agree to be bound by the racing rules as defined in the Notice of Race and Sailing Instructions. I acknowledge that the safety and management of the boat is my sole responsibility and that the organising Authority shall not be responsible for any loss, damage, death or personal injury suffered whilst participating in this Regatta. I declare that the boat will have a valid third party insurance of not less than £3,000,000 for the duration of the races. Details of how to pay will be sent by acknowledgement message. I confirm that: NAME* Name USE OF DATA*Your contact details may be used by the RBYC to get in touch regarding future eventsI agreeI disagreeUSE OF IMAGES*Images of yourself, your crew and/or your boat may be used by the RBYC for publicity.I agreeI disagreeParent/Guardian Declaration*I acknowledge that the organising authority (RBYC) is only able to provide reasonable safety facilities during sailing. In the event of adverse weather conditions, parents or guardians alone must decide whether the child entrant can cope on the water and has adequate safety equipment. I acknowledge that I have sole responsibility for my children/wards during the week and must appreciate that the RBYC cannot be expected to exercise supervision or control. The organising authority accepts no responsibility for any damage suffered by persons or property on or off the water. In an emergency situation I authorise the organisers to take my child to hospital and give my full permission for any treatment required to be carried out in accordance with the hospital’s diagnosis. I understand that I shall be notified, as soon as possible, of the hospital visit and any treatment given by the hospital. Consent for use of images: I grant to the organisers without payment the right in perpetuity to make, use and show any motion pictures, still pictures and live, taped or filmed television of or relating to the event. I agree to notify the organisation of any relevant changes in my child’s circumstances. I confirm that my child is not under a court order. I have read and acknowledge the declaration below Parent/Guardian name* How would you like to pay?Payment Choices* Credit / Debit Card BACS Transfer Credit or Debit Card Cardholder Name Card Number Expires CVV / CVC Postal Code EmailThis field is for validation purposes and should be left unchanged.