Full Name:

e-mail address:

Primary Phone: cell home work other

Alternate Phone: cell home work other

Mailing Address:
Street:
City: State: ZIP:

Age (as of July 22, 2010):

Occupation:

Employer:

The Lobster Run organizers have imposed limitations on the participation of professional sailors in this race, and thus they require all crew to have an ISAF Classification, basically a determination as to whether you are a professional sailor or not. ISAF Classification is free: http://www.sailing.org/classification/first-application.php

What is your ISAF Sailor ID?
and your ISAF Sailor Classification Group? Group 1 Group 3 Not Sure
Expiration Date:

Anything else interesting in your Biography that you would like to share about yourself?
  

For each offshore race or passage (i.e., overnight or longer) that you've done (limit yourself to the last four years or so, if you've done a lot), please list:
   Year, Event or Ports, Distance, Boat Type and Name, Role or Position
for example:
   2010 Lobster Run, 332 nm, Peterson 34 GREYHAWK, watch captain
   2008 Boothbay-Marblehead, 101 nm, Peterson 34 GREYHAWK, helmsman
Use a separate line for each event or passage; if you have a sailing resume in some other format, please paste it below or forward to tim@sailing.thorpeallen.net
  

Please provide the name of a Reference who can vouch for your sailing experience:
   Reference e-mail:
   Reference phone: cell home work other

Do you have any of these credentials or training:

US Sailing Safety at Sea Seminar?
   if so, please give the date and location:

ISAF Offshore Personal Sea Survival Course?
   if so, please give the date and location:

First Aid? if so, please give the name of the certifying organization, level of certificate, and expiration date:
  

CPR? if so, please give expiration date of your certificate:

Any other relevant Skills, Training or Experience?
  

Why are you interested in sailing in the Lobster Run? What are your goals, or what do you hope to get out of this experience?
  

How do you think you can contribute to the overall success of the crew?
  

Are you willing and able to stand watch on a rotating schedule around the clock in all conditions, sailing the boat including steering, sail handling, and other duties as necessary?    Yes No

Do you acknowledge that you understand the nature of this sailboat race, and that you are in good health and proper physical condition to participate in this activity?    Yes No

Will you have you taken all necessary steps to ensure that you are adequately prepared and appropriately equipped for all possible contingencies, such as a prudent seaman would consider advisable, before stepping onboard the boat?    Yes No

To participate in the Lobster Run, you will have to sign a waiver releasing the race organizers of liability. Are you OK with that?    Yes No

We'll collect signatures on the liability form at one of the pre-race events, but if you want to see it in advance, you can download or view a PDF.

For each event on the schedule, please indicate your level of commitment and availability:

Prep Weekend in Boothbay Harbor, Maine, May 22 & 23 (tentative dates)
   Definte Probable Possible Unlikely

   Would an alternate date of June 5 & 6 be better, worse, or no different?

Practice Weekend in Boothbay Harbor, Maine, June 19 & 20 (tentative dates)
   Definte Probable Possible Unlikely

   Would an alternate date of June 12 & 13 be better, worse, or no different?

Boothbay Harbor to Stonington Delivery, July 19 to 22
   Definte Probable Possible Unlikely

Lobster Run Stonington to Boothbay Harbor Race, July 22 to 27(+/-)
   Definte Probable Possible Unlikely

I will certainly try to facilitate carpooling for the pre-race events (there are a number of prospective crew from Connecticut, for example), as well as shuttling cars between Maine and Connecticut for the race itself.

Do you have (or are willing to acquire) the following bits of gear:
Foul Weather Jacket (with hood, retro-reflective patches, seals at wrists)?
Foul Weather Pants (bibs are best, seals at ankles)?
Sea Boots?
Inflatable PFD with integrated Harness?
Strobe or other light attached to PFD?
Whistle attached to PFD?
Tether (with snap shackle at chest, double-action hook at working end; double leads desirable)?

I do have a limited supply of some of this stuff if you need to borrow any of it.

If you have any of these things, feel free to bring them:
Handheld VHF Radio Transceiver
Personal Locator Beacon (PLB), properly registered
Handheld GPS Receiver

Finances

Are you willing and able to cover the costs associated with your participation in this race ($50 per person racer registration fee, $20 per person Stonington Party, $20 per person Boothbay Party, and any other costs associated with your own shore transport and meals)?    Yes No

You don't have to answer these questions right now, but I will need this information from all crew before we go out sailing. The information you provide here will be shared with the rest of the crew on the boat only as appropriate to ensuring safety for all.

Name of Emergency Contact:
Relationship to you:
Contact's Primary Phone: cell home work other
Contact's Alternate Phone: cell home work other
Contact's E-Mail Address:
Contact's Location (e.g. City, State):

Do you have medical insurance? If so, please share information about your coverage that might be needed in an emergency (please provide a photocopy of your insurance card when you first join the boat):
   Insurance Carrier:
   Policy Number:

Are you allergic to anything (food, drugs, bees, etc...)? If so, please indicate specific allergies, types of reactions you have, and how you handle them:
  

Do you have any physical or medical conditions we should know about? (e.g., diabetes, epilepsy, asthma, heart condition, chronic injury, etc...) If so, please explain, including frequency and severity of occurrence, and treatment:
  

Are you taking any medications? If so, please indicate types, names, amounts, frequencies and reasons for the medications:
  
Make sure you bring a sufficient supply! (probably a week's worth for either the delivery or the race, or two week's worth if doing both the delivery and the race!)

Any other questions or concerns, comments or suggestions?