Application Form Nordhavn Atlantic Rally 2004 Instructions



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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)___________________________________________________
1. Name of yacht__________________________________________________

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

Date(s) Description

_______________________________________________________________


_______________________________________________________________
_______________________________________________________________
_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

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:___________________

______________________________ ______________________________
Name:_________________________ Name:________________________

Phone:_________________________ Phone:________________________ Email:_________________________ Email:________________________

Relationship:____________________ Relationship:___________________ ______________________________ ______________________________
61. Who will the crew be and what relevant experience have they had?

_______________________________________________________________

_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________

_______________________________________________________________


_______________________________________________________________
_______________________________________________________________
_______________________________________________________________

_______________________________________________________________


_______________________________________________________________
_______________________________________________________________
_______________________________________________________________

62. List any relevant licenses, training or passages not reflected above:

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________
63. Does the captain have any physical conditions, addictions, or afflictions that would prevent you from or hinder him/her in acting as captain of this vessel for an Atlantic crossing with possibly adverse weather and conditions?

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:

______________________________________________________________


______________________________________________________________

______________________________________________________________

______________________________________________________________
All captains and crewmembers who take part in the rally must agree to be photographed or video taped in connection with the documentary film being made of the rally and, if required, to sign a “model release” agreeing to have their images appear in the documentary at no cost to P.A.E. or to the filmmakers or to any television or cable network or station(s) which may air the documentary or to any companies who may use the documentary for promotional purposes. Will you and your crewmembers agree to this? ٱ Yes ٱ No
I understand, in completing this application, that the Nordhavn Atlantic Rally is intended only for privately-owned yachts and is sponsored by Pacific Asian Enterprises, and I agree and confirm that the yacht which I propose to enter:


  • 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.
photos should be submitted on floppy disk, CD-ROM or Zip disk, which will not be returned to applicants. Please be sure to label any media with the yacht’s name.
ٱ Check in the amount of $1,500 drawn on a U.S. bank payable to Pacific Asian Enterprises or credit card information as shown below. The deposit is fully refundable in the event the yacht is not invited to participate in the rally.
Name on card__________________________

Signature_____________________________

Billing address_________________________

_____________________________________

Telephone____________________________

Check one: ٱ Visa ٱ MasterCard ٱ American Express

Card number___________________________ Expiration date_____________
Send official entry form to:

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.

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