| PayPal info & Closing date | Please complete the form below. Once you press submit you will be required to pay via a PayPal gateway. You do not need to have PayPal account. This service also accepts credit & debit card payments. |
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| Entry Details | |
| Boat Number | 11170 |
| Boat Name | Brian's boat |
| Class Association member | Boats sailing in the Gold, Silver or Bronze fleets shall be entered by members or associate members of the UKWA or any equivalent National Class Wayfarer Association (NCWA) affiliated to the Wayfarer International Committee. |
| Helm Details | |
| Helm Name | Ian Foxwell |
| Helm Date of Birth | 20/02/1965 |
| Helm M/F | Male |
| Helm Address | 94 Bell's Ln ME3 9HU Map It |
| Helm Email | Email hidden; Javascript is required. |
| Helm Phone | 07957666649 |
| Sailing Club | Medway yc |
| Preferred Fleet: | Gold |
| Crew Details | |
| Have you got crew lined up? | Yes |
| Crew Name | Hannah Foxwell |
| Crew Date of Birth | 26/06/1980 |
| Crew M/F | Female |
| Looking for crew | Let us know if you would like us to ask our club members you are looking: club.manager@dabchicks.org When you've got your crew arranged, please email your crew's details to club.manager@dabchicks.org Name: |
| Parent/Guardian Consent | The separate Parent/Guardian Declaration form required for all competitors under 18 years of age as at 29th June 2023, must be completed before the 12pm on 29th June 2023. |
| Social Activity |
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| Allergies / Dietary Requirements | Hannah is allergic to nuts |
| The Entry Fee for 2023 National Championships | The Entry Fee for 2023 National Championships, Qty: 1, Price: £ 125.00 |
| Entry Declaration |  I have read, understood and accept the Risk Statement as found in the Notice of Race item 19 behalf of myself and my crew. |
| Signature (Entrant) |
