Outback Regatta Entry Form - Power Dinghy Racing Club

Member details

First Name *

Last Name *

Mobile Number *

Email Address *

Membership Type *FullJunior (age 14 - 17)Rookie (age 10 - 13)If you are not yet a PDRC member please complete the Membership application first.

Select if entering a Power DinghyPower Dinghy

Select the class you would like championship points awarded to

Race ID *Enter the race Id you would like to allocate points to, If racing under a different race ID please inform the lap counter before the race.

Driver / Co-Driver *DriverCo-driverSelect if you will be the driver or co-driver in your power dinghy class

Select if entering Adventure ClassAdventure

Race ID Adventure *Enter the race Id you would like to allocate points to, If racing under a different race ID please inform the lap counter before the race.

Driver / Co-Driver (Adenture Class) *DriverCo-driverSelect if you will be the driver or co-driver in Adventure Class

Select if entering a Formula 8Formula 8's

Select the class you would like to enter

Race ID Formula 8's *Enter the race Id you would like to allocate points to, If racing under a different race ID please inform the lap counter before the race.

Select if entering a BathtubBathtub

Race ID Bath tub *Enter the race Id you would like to allocate points to, If racing under a different race ID please inform the lap counter before the race.

Rookie Class Entry *F8 Rookies

Race ID Rookie *Enter the race Id you would like to allocate points to, If racing under a different race ID please inform the lap counter before the race.

number of classes entered per competitor

Single entry *Single Entry $30You have entered in one class

Multiple entry *Multiple Entry $40You have entered in multiple classes

Indemnity

I {name-1-first-name} {name-1-last-name}, in entering this event and in consideration of payment of the entry fee, hereby acknowledge that I have read the rules governing the event and agree to abide by the rules and instructions of the events officials, and hereby completely and absolutely indemnify the Power Dinghy Racing Club (Inc) and any and all of its members, employees, officials, officers or helpers of or in any way connected with this event for all actions, claims, costs, demands, damages, expenses, charges, injuries and other losses arising out of or in conjunction with this event regardless of the nature or cause of any occurrence giving rise to such actions, damages, demands, expenses, charges or other losses. I acknowledge that I am entering and/or participating in this event entirely and absolutely at my own risk.

Parent or Guardian details

As you are under the age of 18 please get your parent or legal guardian to complete the following.

First Name *

Last Name *

Contact Number *

Parent or Guardian consent

I {name-2-first-name} {name-2-last-name} confirm that I am the parent or legal guardian of {name-1-first-name} {name-1-last-name}. I agree to the above indemnity and agree to {name-1-first-name} {name-1-last-name} entering this event.

Age restrictions apply for each class, refer to section 22 of the Competition Rules.