REGATTA REGISTRATION FORM

Use TAB KEY or MOUSE CLICK to move through fields
Please check your entries before registering
An email will be sent to the email address you enter with your ticket
If you do not receive it within a few minutes check your Junk folder.
If it is there mark it as not junk so that future emails from LEYC will be placed in your In Box
Problems/changes email: Commodore@LakeEyreYC.com

As we will be driving on a closed road to gain access to the Regatta Camp
the Club will apply for a permit from SA DIT on your behalf.
Fines apply to those driving on a closed road so a permit is mandatory.
The following information is required:

Drivers name shown on Licence
Licence Number
Vehicle Make Model Rego Number
Towing what?
Date In Date Out Now please fill in the Regatta registration form: Firstname Lastname
Preferred Name Member #
Street Town State Pcode
Phone Email
ADDITIONAL PERSONS IN YOUR VEHICLE CHILD U16:
Firstname Lastname Yes No
Firstname Lastname Yes No
Firstname Lastname Yes No
Firstname Lastname Yes No
BOATS WITH YOUR VEHICLE: Boat Class Rego/Sail Number/Name
Boat Class Rego/Sail Number/Name
Boat Class Rego/Sail Number/Name
Number attending Presentation Dinner
Dates arriving/departing Clubhouse at Marree: Before After
Questions/Comments/Additional Information