Phantom

Fleet Name: Phantom

Class Flag: Flag G

Start Lines: Pile House.

Dinghy Entry Form 2021

1Personal Details

2Club & Crew

3Booking

Entries 2021: Please note there is a save and continue later button at the end of the form.
Please click on the save and continue later button to complete or change the form at a later stage or have a copy.
If you use the save and continue later button the form will be emailed to you with a unique reference to allow you to log back into the website to make changes.
Full refunds will be given on event cancellation.
Personal Details
Owners Name*

Joint owned boats enter your names here
Single Owners name*
First Last
Please enter your full name above
Age Group
Please select your age group from the dropdown.
Date of Birth*

Day
Month
Year

Please enter your DOB in the relevant fields e.g. 01 | 04 | 1982
Email*

Your primary email address for correspondence and notices
Phone*
Your main contact number
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
How did you hear about Burnham Week*

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Club & Crew
Yacht Club Name*

Please enter the name of the yacht club that you belong to or are representing
Sail Number*

Please enter the sail number
Dinghy Name*
Fleet*
Please select your fleet from the drop down list
Dinghy Handicap*

Enter your dinghy handicap here listings on www.rya.org.uk
Dinghy type*

Full details please, Radial, 4.7 etc.
Hull Colour*
Helm Name*
First Last
Helms name here please
Crew names
First Name Last Name Crew Age (under 18 only please)
Emergency Contact
Emergency contact list
Name Telephone number

Shore phone contact whilst you are racing (Emergency Notifications)

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Booking
Declaration

I agree to be bound by the Racing Rules of Sailing and by all other rules and instructions that govern this event In particular, I confirm that I have read the Notice of Race and accept its provisions and agree that my boat will conform to the requirements set out in the Notice of Race throughout the event . I confirm that I have valid third-party insurance of not less than £3,000,000
Data Protection*
The information you provide in this form will be used solely for dealing with you as a participant in Burnham Week.

Burnham Week Limited has a Data Privacy Policy which can be found at www.burnhamweek.com. Your data will be stored and used in accordance with this Policy.

Burnham Week Limited may wish to contact you to obtain views about Brurnham Week and /or to promote future Burnham Week Regattas
- I Consent
- I do not consent
Data Protection*
Burnham Week Limited may arrange for photographs or videos of you and any crew to be taken of Burnham Week activities and published on our website or social media channels to promote Burnham Week .
- I consent
- I do not consent
If at any time you wish to withdraw your consent for any of the above, please email info@burnhamweek.com.
Participant's Signature*
Sailing Days
Price:
Sailing Days:*
- Bank Holiday Weekend
- John Torrance Trophy
- Day rate
Total
£ 0.00
Payment Information

Click 'Pay' to be redirected to Paypal to complete your payment securely.
No Paypal account required. Select 'Pay by Debit or Credit Card' to pay by Debit or Credit Card.
Name
This field is for validation purposes and should be left unchanged.

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First Name	Last Name	Crew Age (under 18 only please)

Name	Telephone number

Dinghy Entry Form 2021

Personal Details

Club & Crew

Emergency Contact

Booking

Payment Information