| Sail Number | |
| Bow Number | |
| Division/Class | |
| Boat Name | |
| Mobile/Cellphone number | |
| Current Crew Name | |
| Current Crew Weight | |
| Current Crew Date of Birth | |
| New Crew Name | |
| New Crew Weight | |
| New Crew Date of Birth | |
| Reason for Substitution |
| Date/Time Received | |
| RC Response | |
| Signed | |
| Date/Time |