Base
| Club Membership | |
| Club Membership Number | 2634 |
| Name | new membership 2634 |
| Adult or Youth Member | |
| Parent/Guardian Membership Number | xx |
Boat Details
| Sailing Class or Volunteer | |
| Registration Type | |
| Are you the Boat Owner | |
| Boat Name | eCADna Engineering |
| Sail Number/Insignia | xx |
| Insignia Image | /profiles/21/ecadna.pdf |
| Hull Colour | Gray |
| Spinnaker Colour (Small Rig) | Red |
Personal Details
| Name (First) | Daniel |
| Name (Last) | Gain |
| Date of Birth | 22/01/1985 |
| Gender | |
| Address 1 | 20 Cross St |
| City | Forest Lodge |
| State | NSW |
| Postcode | 2037 |
| Country | Australia |
| Phone | 0408 196 458 |
Emergency Contact
| Emergency Contact Name | Hayley Scrivenor |
| Relationship | Partner |
| Telephone | 0424447336 |
| 2nd Contact Name | Judy Gain |
| Relationship | Mother |
| Phone Number | 0405464123 |
Sailing Australia
| Are you a member of Sailing Austrtalia | |
| Membership Number | 362267 |
| Have you already paid your Membership | |
| Would you like us to pay your membership |
