REGATTARAISING FUNDS FOR AUSTRALIANS CHALLENGED BY LIFE

SINGLE PARTICIPANT REGISTRATION FORM

YOUR DETAILS (1 OR 2 SINGLE PARTICIPANTS)

YOUR ENTRY

$200

PAYMENT DETAILS

My cheque / money order is enclosed OR

Please charge my credit card

Visa MasterCard Amex

Card number:

Expiry Date: - CVC:

Name on card:

Signature:

OR I will pay via EFT Please ensure your name(s) is referenced in payment details

BSB: 032 085 ACCOUNT NUMBER: 451 439 NAME: Sailors with disABILITIES

NAME # 1:

ADDRESS:

PHONE / EMAIL:

NAME # 2:

ADDRESS:

PHONE / EMAIL:

I am interested in finding out about sponsorship opportunities with Making Waves Regatta

Please send completed forms to: events@sailorswithdisabilities.com or post to Sailors with disABILITIES, Level 1, 1C New Beach Road, Darling Point, NSW, 2027

$200

COST ENTRY

1 X SINGLE Entry Fee: $80 | Donation: $120

1 X SINGLE Entry Fee: $80 | Donation: $120

BOAT NAME / PERSON NAME

TOTAL COST:

If you wish to receive a tax deductible receipt for the donation portion of the entry fee please tick here

Entry Fee includes participation in Making Waves Regatta, After Party and Trophy Presentation

FRIDAY 6 MARCH 2020Making Waves

If you have any preference to sail on a particular boat and/or another person, please fill in the name of the person or boat below and we will endeavour to accommodate your request