Application Form Nordhavn Atlantic Rally 2004 Instructions
Download 45.35 Kb.
|
- Navigate this page:
- Application Form Nordhavn Atlantic Rally 2004 Instructions
- Amy Zahra Nordhavn Atlantic Rally Pacific Asian Enterprises 34179 Golden Lantern, Suite 101 P.O. Box 874
- Important : This application must be accompanied by all of the following
- An acknowledgement will be sent after your entry form is received
Application Form Nordhavn Atlantic Rally 2004 Instructions: Complete the following application form on a computer and save it as a MS Word file with your boat name in the following format: boat_name_NAR_app.doc. Return the application electronically (e-mail, diskette, zip disk, or CD) together with the required picture, insurance certificate and documentation or registration certificate (see last page) to reach PAE not later than Monday, Sept. 1, 2003. (Please be sure to label media with the yacht’s name.) Paper copies of the application form and picture(s) are not required or desired; either paper copies or scanned electronic files of insurance certificate and registration copies may be sent. Send the complete application package to: Amy Zahra Nordhavn Atlantic Rally Pacific Asian Enterprises 34179 Golden Lantern, Suite 101 P.O. Box 874 Dana Point, CA 92629 or amy@nordhavn.com First priority in the selection process will be given to applications which reach PAE by the deadline. PAE may not be able to consider applications which arrive after the deadline. We intend to issue invitations to take part in the rally not later than Wednesday, Oct. 1, 2003. Applicants not invited to participate will be notified at the same time. I/we hereby apply for an invitation to take part in the Nordhavn Atlantic Rally 2004 with the full understanding that this rally is by invitation only and that invitations are extended at the sole discretion of P.A.E. Name (of person submitting entry form)____________________________________________ Mailing address______________________________________________________ Daytime telephone______________ Evening telephone______________________ Cellular telephone______________ Onboard telephone_____________________ E-mail address(es)___________________________________________________
2. Documentation or State Registration Number__________________________ 3. Type of yacht (i.e., Nordhavn 46)________________________________________ 3a. Builder (if different from 3 above)________________________________________ 4. Hull number (if applicable)________________________________________ 5. Designer_______________________________________________________ 6. Model year___________7. Year built_____________ 8. Place built_____________________________________________________ 9. Hull material___________________________________________________ 10. Deck material________________________________________________ 11. Cabin or house material_________________________________________ 12. Total fuel tank capacity__________________________________________ 13. Has fuel tank capacity been independently measured? If so, describe method: _______________________________________________________________ _______________________________________________________________ 14. Number of tanks_______________________________________________ 15. Tank material and construction____________________________________ ________________________________________________________________ 16. Reduction ratio (how many engine RPMs per propeller RPM, i.e., 2.5:1)_________________ 17. Usual cruising speed________________ knots 18. RPMs at usual cruising speed______________________________________ 19. Normal fuel burn at usual cruising speed (GPH including generator usual usage)________ 20. Estimated range (with 10% reserve) at: 6.75 knots _______________ NM 7.0 knots_________________ NM 7.5 knots_________________ NM 8.0 knots_________________ NM 8.5 knots_________________ NM 21. Registered owner of yacht_________________________________________ 22. Captain of yacht for this rally_______________________________________ 23. Total number of persons planned on board for this rally__________________ 24. Flag (nationality) of vessel_________________________________________ 25. Home port______________________________________________________ 26. Total LOA (bowsprit tip to swim platform end) ____________ 27. Length on Deck ___________ 28. LWL________ 29. Beam________ 30. Draft_______ 31. Check one: Monohull Catamaran Other___________________ 32. Design displacement__________lbs. 33. Actual displacement_____________lbs. 34. Does the yacht carry ballast? ______ If yes, describe ballast: weight, material, location_____________________________________________________________
35. Number of main engines ________ 36. Engine hours_______________________ 37. Main engine brand, model no., horsepower, and serial number(s) ___________________________________________________________________ ___________________________________________________________________ 38. Describe fuel filtration system for main engine(s), including quantity, location, brand, rated flow, and model number of fuel filters___________________________ __________________________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________________________ 39. Generator 1 brand and size_____________ 39a. Generator 1 serial no. _________________________ 39b. Gen. 1 hours________________ 40. Generator 2 brand and size_____________ 40a. Generator 2 serial no. __________________________ 40b. Gen. 2 hours________________ 41. Description of get-home machinery_____________________________________ _____________________________________________________________________ _____________________________________________________________________ 42. Proven cruising speed of the yacht underway on get-home machinery in flat water?_______________________________________________________________ 43. Is the yacht stabilized? ٱ Yes ٱ No 43a. Describe stabilization system(s) __________________________________________________________________________________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ 44. Hull color__________ 45. House color__________ 46. Deck color_________ 47. Rally rules will require that each rally yacht carry a purpose-built, ocean-approved self-inflating liferaft certified to carry at least the maximum number of persons on board the vessel for any leg of the rally, that the liferaft have an inspection not later than one year prior to the projected end of the rally (July 5, 2004), and that the liferaft have a hydrostatic release to release the liferaft automatically in the event of the yacht sinking. Do you agree to this rule? _____________________________ 48. Yacht’s radio call sign ____________48a. MMSI No. (for DSC only)_________ 49. Will there be a ham radio operator on board for the rally? __________ 49a. Ham radio call sign:______________________ 50. Communications (place an X to the left all communications equipment currently installed and in good operating condition) VHF radio with DSC (digital selective calling) VHF radio without DSC Second installed VHF radio Hand held VHF radio Single sideband transceiver with both ham and marine frequencies Single sideband transceiver with ham radio frequencies only Single sideband transceiver with marine frequencies only Single sideband modem for data transmission and reception Iridium with portable antenna only Iridium with fixed mount external antenna Iridium data port for data transmission and reception Globalstar with portable antenna only Globalstar with fixed mount external antenna Globalstar data port for data transmission and reception Inmarsat C or Mini-C Inmarsat M or Mini-M Inmarsat F-77 Inmarsat B EPIRB – 121.5/243 Mhz EPIRB – 406 Mhz GPIRB – 406 Mhz with built-in GPS Other installed communications: please specify____________________________ ____________________________________________________________________ ____________________________________________________________________ 51. If the yacht carries an EPIRB of any kind, has the EPIRB been registered with NOAA or the appropriate agency of the country in which the vessel is registered? ____ On what date?_____________________ 52. Amount of hull insurance carried on vessel ______________________________ 53. Amount of liability insurance carried for vessel and crew____________________ 54. Name, address, telephone number of insurance agency_____________________ ___________________________________________________________________
55. In the event this vessel is invited to take part in the Nordhavn Atlantic Rally 2004, the owner must agree to have his/her insurance company name Pacific Asian Enterprises as an “additional insured” on the yacht’s insurance policy? Do you agree to this?_________ 56. When and where was the vessel last surveyed and who was the surveyor (name, telephone, e-mail)? ____________________________________________________ _____________________________________________________________________ 57. Is a copy of the survey available to the rally organizers upon request? ٱ Yes ٱ No 58. List significant passages undertaken by rally captain in this vessel
_______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ 59. List any other significant passages undertaken by rally captain or other relevant cruising experience: Date(s) Description _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ 60. List the name at least three references who can vouch for the offshore experience and seamanship skills of the rally captain: Name:_________________________ Name:________________________ Phone:_________________________ Phone:________________________ Email:_________________________ Email:________________________ Relationship:____________________ Relationship:___________________ ______________________________ ______________________________
Phone:_________________________ Phone:________________________ Email:_________________________ Email:________________________ Relationship:____________________ Relationship:___________________ ______________________________ ______________________________
_______________________________________________________________ _______________________________________________________________
_______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ 62. List any relevant licenses, training or passages not reflected above: _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________
ٱ Yes ٱ No If yes, please explain:______________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ 64. Why do you want to take part in the Nordhavn Atlantic Rally 2004?_____ ______________________________________________________________
______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________
______________________________________________________________ ______________________________________________________________ ______________________________________________________________ 65. Please list the person or persons to be contacted in the event there is an emergency during the rally involving you or your yacht: ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________
is privately owned; is not owned by anyone who is an officer or employee of a company which builds, markets, or sells trawler yachts or offshore passagemaking yachts; will not be used to promote, market or sell that brand or model of yacht by any company or entity other than PAE without permission in writing from PAE; will not be used to promote, market, or sell equipment, devices or material which may be aboard the yacht other than equipment, devices or material from companies which are official sponsors of the Nordhavn Atlantic Rally without permission in writing from PAE. Signed:_______________________ (Printed name in lieu of signature has the same meaning and force as signature) Important: This application must be accompanied by all of the following: ٱ Copy of current insurance certificate ٱ Copy of current documentation or registration certificate ٱ One digital color photo (JPG format, minimum size 720 x 540 pixels, minimum resolution 144 pixels per inch, horizontal [landscape] orientation) of the boat underway, shot from the starboard beam. The yacht should come close to filling the frame. Additional digital photos are welcome.
Signature_____________________________ Billing address_________________________ _____________________________________ Telephone____________________________ Check one: ٱ Visa ٱ MasterCard ٱ American Express Card number___________________________ Expiration date_____________
Amy Zahra Nordhavn Atlantic Rally 2004 Pacific Asian Enterprises 34179 Golden Lantern, Suite 101 Box 874
Dana Point, CA 96269 Tel. 949-496-4848 • Fax. 949-240-2398 • www.nordhavn.com An acknowledgement will be sent after your entry form is received. Directory: rally rally -> Rally cars for sale in france rally -> Stop genocide rally -> Competition license application form rally -> Press release no. 1 17. October 2017. Are you ready for a comeback to the gravel? Download 45.35 Kb. Share with your friends:
|