Entry form for registration to Palby Fyn Cup 1 - 3 juni 2012

Please fill in the form and check payment method, then you are enrolled Palby Fyn Cup 2012,
Enrollment fee DKK 600,- rent GPS tracker DKK 150,-
Remember to mrk. payment with: Telephone no. and "Fyncup 2012"
(the fee is incl. breakfast friday morning and soup after end race. Fill in the breakfast field below)

All fields with * are required!

I understand that my registration is only valid, when i have paid the fee of DKK 600,- + voluntary rent of GPS tracker DKK 150,-
to Nordfyns bank.

I certify that the registered boat will be adeqately equipped and staffed to carry out the race,
and I am a member of a yacht club recognized by the national authority.

This registration is binding.

Best regards

Bogense Sailling Club- Sejlerkajen 4, - DK 5400 Bogense - Denmark

Bank: NORDFYNS BANK, konto nr. 6860 - 1068262
IBAN:DK1668600001068262
S.W.I.F.T: SYBKDK22
OWNER:*
BOAT TYPE :*
ADDRESS/NO.:*
SAIL NO :*
POSTALCODE/CITY:*
BOAT NAME :*
PHONE /MOBILE:*
BOAT COLOR :*
E-MAIL:*
YACHTCLUB:*
Palby Fyn Cup
CERT. NO:*
I WANT TO SAIL IN RACE :*

(GPH)

WITHOUT SPINNAKER :
HANDICAP:
   
BREAKFAST/NO
    Rent GPS Tracker: