SOUTHPORT YACHT CLUB Sailing Series ENTRY FORM

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2014-2015 Sailing Series ENTRY FORM Boat Name Sail Number VYC/CBH/HANDICAP Design/Class: Person-in-Charge Name: Alternate Skipper Name: YA Silver Card Number Crew Member: Member of SYC NO Gold Country Intermediate Cadet Sailing Family Sailing Home Street Address Suburb Post Code Mobile Phone Fax Number E-Mail Address OTB Dinghy Fees Winter Series* $65 Sprints Series* $165 Casual Entry $20/Race $360 Championship Series* $165 Trophy Races Only (TK,TMR,COTB)* $60 OTB Multihull Fees $415.00 BEN S GARAGE DOOR SERVICES Championship Series* $165 BEN S G.D.S. Passage Series* $105 BEN S G.D.S. Offshore Series* $95 STEFAN s Wed Twilight Series $155 CMN FIRE BRIGADE Bridge to No Bridge* $45 BEN S G.D.S. Winter Series* $65 Casual Entry $20/Race INSHORE Div. Fees $475 OFFSHORE Div. Fees Vessel Registration #:... $375 GiLL Inshore Summer Series* $165 STEFAN s Wed JaM* $125 SEA BREEZE INDUSTRIES Etchell Champs $660 WILD OATS Spring Twilight Series* $95 BOSUNS LOCKER Series* $75 Julian Rocks Yacht Race $45 CMN FIRE BRIGADE Bridge to No Bridge* $65 STEFAN s Wed Twilight Series* $155 CLUB MARINE Brass Monkey Series* $75 WILD OATS Summer Twilight Series* $95 Offshore Winter Series* $55 Cook Island Yacht Race $35 GiLL John McNamara Memorial Race* $25 STEFAN s Fri JaMaS Series $125 Casual Entry $20/Race WILD OATS Winter Twilight Series* $95 Casual Entry $20/Race Cash Cheque EFTPOS Visa MasterCard American Express(+3.5%s.c.) Credit Card Number Bailment Yes / No Credit Card Expiry Date / / Cardholder Signature X Note: *Whole Season entry excludes SYC Special Events such as Sail Paradise, Cat Weekend etc refer to Handbook SI s. *Included in Bailment Page 1 of 7

2014-2015 Summer Series Entry Form DECLARATION BY PERSON IN CHARGE: I declare that all the above details are correct. I agree to be bound by the ISAF Racing Rules for Sailing, the Prescriptions and Special Regulations of Yachting Australia, the relevant Class Rules, the Notice of Race, the Sailing Instructions and any other rules or Regulations which govern the Series. I acknowledge that Southport Yacht Club Inc (SYC) is not responsible for the seaworthiness of a boat whose entry is accepted or the sufficiency or adequacy of its equipment. Furthermore I agree to indemnify SYC from any responsibility in regard to myself, my crew and my vessel during this Series. I agree that this indemnity extends to all Officers, Sponsors and Agents of SYC. I understand my obligation under RRS Fundamental Rule 4, which states, The responsibility for a boat s decision to participate in a race or to continue racing is hers alone. I agree that SYC and their employees and volunteers may exchange information about me that includes the information I provide to administer my entry into the Series and to run their business. I agree that the name of the boat and her crew nominated in my entry and my results may be used by SYC to publicise and promote activities at SYC and may be released to the press for public audience. I agree that all information may be disclosed to necessary stakeholders in emergent situations and when bound by law to do so. I agree that SYC may use the information that I provide to inform me of other events and club promotions. If I do not want this I can let them know. SIGNATURE OF PERSON-IN-CHARGE X DATE / / 20 Signature of Parent/Guardian is required if Person-in-Charge is under the age of 18 years SIGNATURE OF PARENT/GUARDIAN X DATE / / 20 OFFICE USE ONLY RECEIPT # DATE / / 20 CMS INPUT TY BY: DIVISIONAL DB UPDATED BY: Page 2 of 7

SAFETY DECLARATION OF COMPLIANCE YACHTING AUSTRALIA SPECIAL REGULATIONS PART 1 Keel, Trailable and Multihull CATEGORY 3 - SAFETY EQUIPMENT COMPLIANCE FORM DECLARATION BY OWNER OR REPRESENTATIVE: I have read and understand my obligations as set out in the Yachting Australia Special Regulations 2013-2017, in particular 1.02(.1), (.2) & (.3) Owner s Responsibility. I understand that the audit is carried out only as a guide to Owners and Race Organising Authorities. An auditor cannot limit or reduce the complete and unlimited responsibility of the Owner or the Owner s Representative as defined in 1.02(.1), (.2) & (.3) Owner s Responsibility. I undertake to maintain the boat and all its equipment in good order and condition as specified in these Regulations. BOAT NAME SAIL NUMBER SIGNATURE X DATE NAME OF PERSON-IN-CHARGE Page 3 of 7

SAFETY DECLARATION OF COMPLIANCE YACHTING AUSTRALIA SPECIAL REGULATIONS PART 1 Keel, Trailable and Multihull CATEGORY 4 - SAFETY EQUIPMENT COMPLIANCE FORM DECLARATION BY OWNER OR REPRESENTATIVE: I have read and understand my obligations as set out in the Yachting Australia Special Regulations 2013-2017, in particular 1.02(a), (b) & (c) Owner s Responsibility. I understand that the audit is carried out only as a guide to Owners and Race Organising Authorities. An auditor cannot limit or reduce the complete and unlimited responsibility of the Owner or the Owner s Representative as defined in 1.02(a), (b) & (c) Owner s Responsibility. I undertake to maintain the boat and all its equipment in good order and condition as specified in these Regulations. BOAT NAME SAIL NUMBER SIGNATURE X DATE NAME OF PERSON-IN-CHARGE Page 4 of 7

SAFETY DECLARATION OF COMPLIANCE YACHTING AUSTRALIA SPECIAL REGULATIONS Monohulls or Multihulls CATEGORY 6 (SYC) SYC SAFETY EQUIPMENT COMPLIANCE FORM For Short Races with effective rescue availability close to shorelines in Protected water in daylight Or Sheltered waters at night Sail No. Boat Name Owner/s LOA Displ tonnes Max Crew State Maritime Hull Registration No. Hull material Hull colour Distinguishing Marks Deck material Deck colour Owner/s YA Membership No. Club Compliance Form valid until 30 th June of the year following the date of this form, or / / whichever is the earlier. DECLARATION BY OWNER/OWNER S REPRESENTATIVE I have read and understand my obligations as owner set out in the Yachting Australia Special Regulations 2013-2017 in particular 1.02.1, 1.02.2 and 1.02.3 - Owner s Responsibility. I understand that this audit is carried out only as a guide to owners and organising authorities. An Auditor/inspector cannot limit or reduce the complete and unlimited responsibility of the owner or owner s representative as defined in regulations 1.02.1, 1.02.2 and 1.02.3- Owner s Responsibility. I undertake all of its equipment as specified in the Yachting Australia Special Regulations 2013-2017 will remain on the boat and continue to be in good condition and repair. Signed by Owner/Owner s Representative: X Date / / EQUIPMENT AUDITOR/INSPECTOR DECLARATION I have checked the equipment in accordance with 2.02.2 summarised in the following list for the above mentioned boat and the equipment listed was found to be on board at the time and date of this Audit. Audited by (print name) Signature of Auditor X Date / / MYA accreditation No State Maritime Authority Sticker issued YES / NO (If applicable) NOTE: Auditors do not inspect items referred to in Regulations 2.04; Section 3 Part 1; or Part 6. (refer to 2.02.2). Owners must satisfy Organising Authorities as to those items when required to do so. Yachting Australia Special Regulations 2013-2017 Equipment List Reg Equipment Pass 2.03.1 Equipment adequate for intended use 2.03.2 Ballast heavy equipment secured 3.06.1(b) If carrying fuel or gas below decks then 2 exits 1 forward of mast; minimum clearance 450mm for Age/Series Date 07/2010 or later 3.06.1(d) For yachts with Age Date on or after 07/2014, requirements of ISO 9094 must be met. 3.07.1 Open outward, except less than 0.071m 2 3.07.3 Blocking device for low sill companionway 3.07.4 (a) 3.07.4 (b) Companionway hatch strong securing arrangement securing hatch in closed position (i) operable from above and below Blocking Devices (i) retained hatch open or shut (ii) secured (iii) permit exit in event of inversion 3.08.1 Cockpit strong, self draining at all angles of heel, permanent and integral part of hull 3.08.2 Cockpit essentially watertight 3.08.3 Bilge pump outlet not connected to cockpit drain 3.08.4 Cockpit sole 2% LWL above LWL 3.08.5 Bow, lateral, central, stern wells, in cockpit volume 3.08.7 Number of cockpit drains 3.08.8 Multihull minimum drain sizes after allowance for screen 20cm 2 per m 3 3.09.1 (a) Sea cocks permanently installed. (b) Plugs for each opening attached 3.12.6 If fitted (a) Lifelines uncoated stainless steel wire (b) Lifeline coating not moulded to wire (d) Gap secured by lanyard 100mm or less Lanyard replaced annually (e) Strength lifeline system, wire size comply Page 5 of 7

3.14.2 Toe rail not required on multihulls 3.17.2 Cooking stove if installed securely fastened, accessible shutoff 3.17.3 Gas only permitted for cooking Methylated spirits acceptable for cooking (a) REMEMBER to turn off Gas sign 3.17.4 (b) Gas detection system if appliance uses a pilot light 3.17.5 Disposable gas canister 225 gms or less 3.17.6 Gas bottle, spare canisters in separate, ventilated, self draining locker, vapour can escape overboard 3.18.4 Emergency drinking water 9 ltrs 3.20.1 Bilge pump not to discharge into closed cockpit or cockpit drains 3.20.2 Bilge pump minimum suction bore 25mm & strum boxes accessible 3.20.8 1 manual pump if space below floorboards precludes access for bucket bailing 3.20.9 2 x 8ltr buckets stout construction with lanyard 3.23.1 Navigation lights 3.23.4 Reserve Navigation lights 3.24.3 Inboard engine to SR 3.24.1 & 3.24.2, OR outboard engine with tanks, fuel supply securely fastened 3.24.4 Outboard motors mounted at all times, may be raised but not removed 3.24.6 Separate starter battery 3.24.7 Separate generators, if permanently installed, covered; permanent exhaust, fuel supply & tank 3.24.8 If motor installed/carried; Fuel tank shut off valve/cocks(s) (a) Inboard petrol tanks permanently installed, metal, vented to open air, electrically grounded, filler position prevents fuel/vapour entering boat 3.24.9 (b) diesel tanks metal or other certified material (c) fuel lines comply (d) outboard motor remote fuel tank & lines comply (e) no petrol in portable containers below deck (f) no flexible diesel tank unless incorporating a liner 3.24.10 If no motor & 5.5m or less; oars/paddles; blade area 0.04m 3.25.1 Radio frequencies comply with table 3.25.3 (i) VHF min power 25 watts 3.28.1 Hull Identification, name, number, club 4.01.1 Sail numbers (a) fire extinguishers to AS1841.4 / AS1841.6, readily accessible, inspection Date / / (b) if naked flame, auxiliary engine then 1 x 10BE 4.04.1 (c) if LPG or petrol below deck additional 1 x 10BE (d) Fire blanket if cooking facilities (e) Fire Extinguisher s shall be serviced/tested, by an authorised person, according to the Manufacturers Ins. (a) Anchor & ground tackle as per Table 1 (b) Anchor & warps sizes as per Table 2 or Table 3 4.05.1 Type.. kgs.. (d) Bitter end strong point 4.06.2 flashlight floating type, spare batteries & bulbs 4.07.2 First aid manual 4.07.3 Medical Kit, at least items in 4.07.8 and NoR Medical Kit waterproof container Alternative brands permitted Panadol or Nurofen x 20; Disprin x 20; Disposable gloves x 10; Crepe bandages75mmx1.5m x 2; Bandaids x 4.07.8 20;Adhesive tape 50mmx2.5m x 1; Non adherent dressing x 5;Antiseptic skin solution 15ml x 1;Alcohol swabs x 10; Solugel 100mgs x 1;Sunscreen 30+SPF 250ml x 1; s/s scissors ; Safety pins x 10; CPR mask or 6 x face shields 4.10.3 YA Racing rules 2009-2012 4.15.3 Sharp knife sheathed, restrained in or near cockpit 4.16.1 Name on all buoyant equipment & items 4.16.2 Personal PFD marked to identify owner 4.17.1 Reflective tape lifebuoys, lifeslings, liferafts & PFDs Boat Name Page 6 of 7

Waterproof container 4.22.1 Flares 2 x red hand 2 x orange smoke Earliest expiry date / / 4.27.1 V Distress sheet or International signal (a) Number PFDs 5.01.1 (f) Number PFD Type 1.. Number PFDs Type 2.. (g) If no lifelines complying 3.12, then PFD Type 1 or 2 worn by each crew on deck 5.01.2 & 5.01.3 complying with AS1512 or AS1499 or AS4758 or equivalent or more stringent overseas standard Branded with respective standard mark of approval 5.01.4 (i) Marine grade retro-reflective tape (ii) Whistle attached 5.01.5 If inflatable, compressed gas system 5.01.6 (a) Each inflatable PFD1 Service date / / (b) Each non inflatable PFD annual check ADDITIONAL EQUIPMENT IF ANY REQUIRED BY NOTICE OF RACE OR SAILING INSTRUCTIONS. Boat Name Page 7 of 7