Cookham Regatta 2024

Cookham Fun Regatta 2025

Dragon Boat Entry Form
Crew Name*
Club / Organisation (if applicable):
Crew Profile (optional) Please say something about your team that we can put on the Regatta web site
Contact Details
Name (First Contact)*

First NameLast Name
Address

Address Line 1

Address Line 2

CityCounty

Postcode
Mobile*
Landline
Email*
example@example.com
Name (Second Contact)

First NameLast Name
Address

Address Line 1

Address Line 2

CityCounty

Postcode
Mobile
Landline
Email
example@example.com
Crew Details
NOTE: Entry date is taken from first receipt of the form including payment of Race Entry Fee, however full Crew details may be added later up until the 6th September.

Final substitutions subject to the entry rules may be accepted on the day subject to organizer’s discretion.
Name Crew 1 (Captain)

First NameLast Name
Age if under 18
Name Crew 2

First NameLast Name
Age if under 18
Name Crew 3

First NameLast Name
Age if under 18
Name Crew 4

First NameLast Name
Age if under 18
Name Crew 5

First NameLast Name
Age if under 18
Name Crew 6

First NameLast Name
Age if under 18
Name Crew 7

First NameLast Name
Age if under 18
Name Crew 8

First NameLast Name
Age if under 18
Name Crew 9

First NameLast Name
Age if under 18
Name Crew 10

First NameLast Name
Age if under 18
Name Crew 11

First NameLast Name
Age if under 18
Name Crew 12

First NameLast Name
Age if under 18
Name Crew 13

First NameLast Name
Age if under 18
Name Crew 14

First NameLast Name
Age if under 18
Name Crew 15

First NameLast Name
Age if under 18
Name Crew 16

First NameLast Name
Age if under 18
Start time for the regatta will be promptly at 10.00am If your team has a good reason for avoiding the heats before 11.00am then please show your earliest available time
Reason
Payment
Payment method*

BACS sent to 'Cookham Regatta' Sort Code 60-13-35 Account No. 56468997 Reference: your Crew NameCHEQUE made payable to ’Cookham Bridge Rotary Club Regatta Account’ with Crew Name on the reverse and posted to:Regatta Entries, 31A Victoria Road, Eton Wick, Berkshire, SL4 6LYOTHER
If not paying by BACS or CHEQUE please state your payment method below:
Privacy statement
All personal information is kept confidential and will not be revealed to any third parties. Please go to the Race Entry page for our full privacy statement.

Please tick the adjacent box if you are happy to receive information about future Regattas
Agreement & Authority
You must tick the box below*

As first contact listed above I confirm that all my crew and I agree to abide by the Cookham Regatta Rules and Conditions. In particular we agree that the race organisers shall not be liable for any loss, damage, death or personal injury howsoever caused as a result of taking part in this event. I confirm that all my crew and I are competent swimmers and I have their authority to enter them into this event and commit them to the above agreement. I also confirm that I have the written authority of a parent, guardian or responsible person for all crew members under the age of 18 years.
Should be Empty:

Cookham Fun Regatta 2025

Contact Details

Crew Details

Payment

Privacy statement

Agreement & Authority