NSSA Regatta
Please fill in this form in full, so that I can complete the team entry form for Derbyshire. You can pay by bank transfer into the DYS account
Account name: Derbyshire Youth Sailing
Sort Code: 60 12 01
Account Number: 25119524

Entry Fee for Singlehanders Early Bird before 12th June £140 Late entry £150 (inc. all social events)
Entry Fee for Doublehanders Early Bird before 12th June £225 Late entry £235 (inc. all social events)

Please note the team entry needs to be submitted by the 12th June to qualify for the early bird discount, so please complete the form and make the bank transfer by 28th May (so I can complete the relevant forms)
Email address *
Sailor's first name *
Your answer
Sailor's last name *
Your answer
Single/double hander Helm/crew
Boat Class eg Laser Radial, Topper
Your answer
Sail number
Your answer
Main or Rookie Fleet
Date of Birth
Your answer
Male/Female
Medical information and medication being taken during regatta- please state none if none
Your answer
Individual's NSSA Membership Number
Your answer
Name of responsible adult accompanying sailor
Your answer
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