Event registration

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Details

Ice Breaker Regatta 2026

Sat 19 Sep 2026 12:00PM - Sun 20 Sep 2026 4:00PM

Lake Eppalock

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First name*

Last name*

Phone number*

Email address*

Address*

Name of skipper*

Skipper DOB*

Name of Home Club

Australian Sailing Number -Skipper*

Name of Emergency Contact*

Phone Number - Emergency Contact*

Relationship to Emergency Contact*

Name of Crew 1

Phone number - Crew 1

Australian Sailing Number - Crew 1

Name of Crew 2

Phone number - Crew 2

Australian Sailing Number - Crew 2

Class of Boat*

Name of Boat

Sail number*

Entry Fee - Junior

$30.00 ea

Entry Fee - Senior Single Handed - before 6pm on 16/9

$70.00 ea

Entry Fee - Senior Crewed Class - before 6pm on 16/9

$85.00 ea

Camping Fees - per site per night

$20.00 ea

Saturday Dinner - Spit Roast + Dessert

$35.00 ea

Saturday Dinner - Vegetarian Meal + Dessert

$35.00 ea

I am over 18, or, if I am under 18, this registration has been filled out by and endorsed by my parent or guardian.*