16 Mitala Street, Newport NSW 2106   Tel: 61 2 9998 3700

     

16 Mitala Street, Newport NSW 2106
Tel: 61 2 9998 3700

Youth Membership Nomination Form
YOUTH DETAILS
Gender
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Given Name(*)
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Surname(*)
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Date of Birth
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Postal Address(*)
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Residential Address(*)
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Home Telephone
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Mobile
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Email Address(*)
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Emergency Name and Contact number(*)
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Are you or have you been, a member of another club?
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If Yes please provide the name of club (s)
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Have you ever been a member of the RPAYC?
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If Yes, please provide Membership number
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Australian Sailing (AS) membership - AS membership is complimentary with RPAYC Membership. If you are an existing member, please give details below.
Are you a member of Australian Sailing?
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My Australian Sailing Number is?
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My home Club is?
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If elected as a member of RPAYC, I agree to the above personal details being provided to AS
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Club Activities & Interests
Which activity or activities are you interested in participating?
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Name of Boat
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Type of Boat (eg- Optimist, Laser)
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Sail Number
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Boat is insured with?
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Vessel Insurance expiry date?
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Policy Number
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Please upload current vessel Insurance Forms
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Do You Require rack storage
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Club Notices and Communications will be forwarded by email, unless otherwise stated
Which of the following Club publications would you like to receive?
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Where did you hear about us
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Candidate declaration
PLEASE INITIAL TO INDICATE THAT: I certify that the information provided is true and correct. I hereby consent to be proposed for membership and to provide any other personal information The RPAYC may require to determine my application for membership. I hereby consent that if elected, I agree that members are bound by the Constitution and By-Laws of The Royal Prince Alfred Yacht Club
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Part Two - Parent/Guardian details (required if Youth applicant is between 6 - 18 years of age)
Full name of parent or guardian 1(*)
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Parent or Guardian 1 Membership Number, if Applicable
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Parent or Guardian 1 Postal Address
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Parent or Guardian 1 Residential Address (*)
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Parent or guardian 1 Home Telephone
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Parent or guardian 1 Mobile (*)
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Parent or Guardian 1 Email Address (*)
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Full name of parent or guardian 2
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Parent or Guardian 2 Membership Number, if Applicable
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Parent or Guardian 2 Postal Address
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Parent or Guardian 2 Residential Address
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Parent or guardian 2 Home Telephone
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Parent or guardian 2 Mobile
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Parent or Guardian 2 Email Address
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PLEASE INITIAL TO INDICATE THAT: I/We certify that the above information is true and correct to the best of my knowledge(*)
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PLEASE INITIAL TO INDICATE THAT: In accepting the application of my son, daughter or charge as a Youth member (between 6 and 22 years or age) of The Royal Prince Alfred Yacht Club, I confirm that your officers, servants, employees and agents are free and clear of all liability and responsibility whatsoever for any accident, illness, negligent act or misadventure, which may occur of befall him / her in participating in any activity connect with the Club and indemnify the Club, its officers, servants, employees and agents from and against all damage, claims and demands whatsoever in respect thereof. I further authorize you in the event of any accident, illness, negligent act or misadventure, to obtain any and all medical assistance and hospital accommodation that may be necessary and in this event, I agree to pay all medical and all other expenses and fees incurred on behalf of this applicant.(*)
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Validation
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About RPAYC

The Royal Prince Alfred Yacht Club - RPAYC is a yacht racing and sailing club based on Pittwater.

The yacht club offers year round inshore and offshore racing, cruising, centreboard dinghy racing, sail training and courses plus has a large marina accommodating up to 352 vessels.

There is also a modern boatyard with comprehensive marine services to help maintain your vessel.

Membership, including family membership is now available.

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