Return entries to: Diarmuid Marron, Topaz Class Captain, Malahide Yacht Club, St.

James Terrace, Malahide, Co. Dublin

MALAHIDE YACHT CLUB

TOPAZ CLASS ASSOCIATION OF IRELAND LEINSTER CHAMPIONSHIPS June 22nd, 2013

ENTRY FORM
Details of boat Type of boat (tick as appropriate) Sail number* _____________ Topaz Uno _____ Topaz Uno Plus ______ Hull colour ___________

Sail colour __________

*The manufacturers hull number is used as the sail Number

Entered by

Name Address Club

_______________________________________________________________ _______________________________________________________________ _______________________________________________________________

Sailors Details (date of birth only required if under 18 on day of regatta) Helmsperson (if different from above) _________________________________________ Date of Birth _________________ Crew (for Uno Plus) DECLARATION _________________________________________ Date of Birth _________________

1. I agree to be bound by the Racing Rules of Sailing, the prescriptions of the ISA, the Notice of Race, the Sailing Instructions, any
amendments thereto and the relevant Class Rules.

2. I acknowledge that I enter and sail at my own risk and that the race committee, Malahide Yacht Club or the Topaz Class Association of
Ireland will not be liable for any loss or damage to yachts or equipment or for injury to persons.

3. I am fully aware of the actual and potential risks involved in active water sports, including drowning, hypothermia and other physical
injuries. I accept that, by engaging in active water sports, my physical safety and that of my crew could be endangered. I am also aware that other competitors actions and the actions or inactions of the organisers of water sports events, including the drivers of escort craft, can also endanger my physical safety. I acknowledge that it is up to me personally to assess whether any event or activity on the water is too difficult for me. I acknowledge that the safety of my boat and its entire management, including insurance, is my sole responsibility and I am satisfied that the yacht and helm are adequate to face the conditions that may arise in the course of the races. I confirm that my boat will be covered by third party insurance cover providing a minimum indemnity of 1.5million for the du ration of the regatta.

4. 5.

Entrants Signature

_______________________________ _________________ (mobile)

Date ________________

Phone Numbers

_________________ (home)

Sailors less than 18 on the day of the regatta must have this form countersigned by their parent or guardian.

For helm I, the parent/guardian of __________________________ , having read the declaration above, confirm my agreement to its terms and my approval to his/her participation in this regatta. Signed: ____________________________________ Date: __________________ For crew I, the parent/guardian of _________________________ , having read the declaration above, confirm my agreement to its terms and my approval to his/her participation in this regatta.

Signed: _______________________________________

Date: __________________

Entry fees

Uno 25.00

Uno Plus 35.00

__________

A discount of 5 per entry will apply for completed and paid entries received by 15th June 2013

I enclose Cash / Cheque payable to

Malahide Yacht Club

for

_________

Please Note that membership of the Topaz Class Association of Ireland is not included in the above entry fees. Topaz Class Association of Ireland Membership/Renewal

Topaz Class Association membership renewal is required.

The following fees apply : Cadet Member 5.00 each U18, or in Full time Education Adult Member 10.00 each 15.00 per family quantity ___________ quantity __________ quantity __________ __________ ___________ ____________

Family Membership

NB Please make cheques payable to : Topaz Class

Association of Ireland for association renewal only