Mario Ambrosino 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.

Power Dinghy ClassStandardSuper StandardSportsChampionship points will be allocated to this class

Race ID *Enter you Race ID for Power Dinghies

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

Adventure ClassAdventureSelect if entering Adventure Class

Race ID - Adventure *Enter you Race ID for Adventure Class

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

Formula 8'sF8 MensF8 LadiesIf entering a Formula 8, please select your class

Race ID - Formula 8 *Enter you Race ID for Formula 8's

BathtubsBathtubPlease select if entering a Bathtub

Race ID - Bathtub *Enter you Race ID for Bathtubs

Rookie Class Entry *F8 Rookies

Race ID *Enter you Race ID for F8 Rookies

Single or Multiple entry *Single $30Multiple $40If you have entered in more than 1 class tick multiple. Eg power dinghy and bathtubs,

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.