APPLICATION FOR RENEWAL OF MEMBERSHIP 2019-2020

I, First Name Middle Name(s) Surname

of Unit and/or Street no. Street name Suburb State Postcode

Phone No.: Phone No. Home or Work? Mobile No.: Mobile no.

AS No. if known: AS No. BPYC No. if known: BPYC No.

Email Address: Applicant’s personal email address

agree to renew my membership for the year 2019-20 due 30 June 2019 @ $80.00 per annum.

☐ I request that information above, other than my name, is not open for inspection by any member of BPYC other than for the purposes allowed in the BPYC Constitution (click box if requesting)
Warning: NSW Roads & Maritime requires the Club to warn participants in Club events that there are particular risks in such participation, including but not limited to injury or death due to collision, gear breakage or water immersion. A current Category 7 Safety Certificate and BPYC Addendum – Other Safety Equipment Requirements is required for all boats. By completing and lodging this form, together with relevant fees, you acknowledge those risks and that requirement. You also acknowledge that any crew member who sails in more than three races in a season anywhere in Australia shall be a member of a club affiliated to Australian Sailing and an Australian Sailing card holder (SIN).

Date: Select date

If applicable:

Name of Yacht: Yacht Name	Sail No.: Sail No.
Hull Colour: Colour	Design: eg, Beneteau 34	Club: Club Name

MEMBERSHIP FEE

Annual Subscription $80.00

All Club members have, or will receive, an Australian Sailing number (SIN) at no additional cost.

SERIES RACE ENTRY FEES (for yacht owners) – Click all appropriate boxes below

☐ 1st series entered – 8 races – Spring or Autumn $100.00	OFFICE USE ONLY:
☐ 2nd series entered – 8 races – Spring or Autumn $ 50.00	Date Entered: Select date
Date Paid: Select date

Casual Entry is $20.00 per race.

TOTAL PAID: $ Enter Annual Membership Fee + Series Race Entry Fee(s) paid

Payment may only be made by Direct Credit to Westpac BSB 032003 Account: 269407 Ref: BPYC Membership No. or Surname