NSSA SINGLE HANDED TEAM RACING CHAMPIONSHIP
Aztec Upton Warren, Bromsgrove, B61 7ER
8th and 9th October 2016
REGATTA ENTRY FORMNAME OF TEAM(S) / NSSA Membership No
TEAM NAME(S) / U
12 / U
16 / NAMES AND NSSA MEMBERSHIP NUMBER OF TEAM MEMBERS
1 / Name / Name / Name
NSSA No / NSSA No / NSSA No
2 / Name / Name / Name
NSSA No / NSSA No / NSSA No
3 / Name / Name / Name
NSSA No / NSSA No / NSSA No
4 / Name: / Name: / Name:
NSSA No / NSSA No / NSSA No
Please rank teams as A, B, C etc, based on team racing ability.Under 12 or 16 teams must consist of three competitors who will be under 12 or 16 on the start date of the event. If you cannot provide the names of team members now, please photocopy the entry form and send details later.
REGATTA AND CATERING FEES
No of Teams
ENTRY FEES / @ £75 per team / £
ACCOMMODATION, CATERING AND ENTERTAINMENT
Total as detailed on the Accommodation, Catering and Entertainment Form / £
TOTAL FEES
Please make cheques payable to WSSCA / £
NOTE – Entry Fees, Accommodation, Catering and Entertainment charges are NON REFUNDABLE
DAMAGE DEPOSIT
Please make cheques payable to NSSA / @ £100 per team / £
NOTE – Damage deposit cheques, less any cost of damageor loss will be returned as soon as possible after the event
TEAM MANAGER DETAILS
NAME
ADDRESS
Home Telephone / Mobile Telephone / Email
DBS Number / DBS Issue Date
Declaration
I have read the Disclaimer of Liability and the Parent/Guardian Declaration on the Personal Registration form and understand my responsibilities as the Team Manager, and where appointed by the parent/guardian, the person appointed in loco parentis. I confirm that I and other adults accompanying the team have current (within three years) enhanced clearance. I confirm that the above named competitors are bona fide members of our organisation, which in turn is a fully paid up member of NSSA.
Signed / Date
ADULT HELPERS DBS INFORMATION
Name / DBS Number / DBS Issue Date
Name / DBS Number / DBS Issue Date
ADDITIONAL ADULT HELPERS WILLING TO ASSIST
Name / Is willing to help on the shore Yes / No / On the water Yes / No
Name / Is willing to help on the shore Yes / No / On the water: Yes / No
CLOSING DATE FOR ENTRIES – FRIDAY 16thSEPTEMBER 2016
Return to: Vivien Brookes, 109 Guarlford Road, Malvern, WR14 3QU
01684 569253 or 07880 944170
NSSA SINGLE HANDED TEAM RACING CHAMPIONSHIP
Aztec Upton Warren, Bromsgrove, B61 7ER
8th and 9th October 2016
ACCOMMODATION, CATERING AND ENTERTAINMENT FORMNAME OF TEAMS
Number of hotel rooms required on Friday night / @ £50 per room / £
Number of hotel rooms required on Saturday night / @ £50 per room / £
Number of lunches required on Saturday at Upton Warren / @ £5 each / £
Number of evening meals required on Saturday at a local pub / @ £8 each / £
Number of ten pin bowling places required on Saturday evening / @ £5 each / £
Number of hotel rooms required on Saturday night / @ £50 per room / £
Number of lunches required on Sunday at the Sailing Club / @ £5 each / £
TOTAL - To be included with Entry Fees – See Other Sheet / £
Please list any special dietary requirements for your team (including vegetarian)
ACCOMMODATION SUMMARY
TEAM DETAILS / MALE / FEMALE / NOTES
Number of competitors /
- Mixed teams must be supervised by both male and female adults at all times.
- Accommodation is in family rooms to accommodate up to 2 adults and 2 under 16’s.
- We have a limited number of rooms available at £50 per room per night and they will be allocated on a “first come, first served basis”.
- Room bookings include breakfast, car parking and wi-fi.
Numbers of rooms required for competitors
Number of adults
Number of rooms required for adults
Total number of rooms required
SATURDAY EVENING ENTERTAINMENT
Ten pin bowling is available on Saturday evening at a cost of £5 per person for one game. Transport to the venue will be the responsibility of Team Managers. Ten pin bowling must be pre-booked and paid for.
CLOSING DATE FOR ENTRIES – FRIDAY 16thSEPTEMBER 2016
Return to: Vivien Brookes, 109 Guarlford Road, Malvern, WR14 3QU
01684 569253 / 07880 944170