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 |
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 |