Visiting Boat Form

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Apologies - But This Page Is Faulty - Please DON'T Try To Submit A Visiting Boat Form Until Further Notice!

Please Email treasurer@jurienmarinerescue.com.au for a visiting boat form to be emailed to you (you will need to print it out to complete it), call in at our rescue tower to fill in a paper form, or phone our tower on 9652 1950 with your details. Many Thanks.
Our Sincere Apologies For The Inconvenience.

Last Name

First Name

Date of Birth

Mobile Phone - preferably a phone that will be carried on the boat

Alternate Contact - such as next of kin

Phone Number for Alternate Contact

Home Address - your normal place of residence

Other Groups - such as marine rescue group or club

Alternate Phone Number - another contact for while you are away

Holiday Address - where you are staying during your visit

Holiday Start Date

Holiday End Date

Name of Boat

Callsign - any other call sign you typically use

Registration Number

Make and Model

Material - fibreglass, aluminium etc

Length (metres)

Type of Boat - centre-console, half-cabin etc

Colour

Engine - number, make and horse-power

Fuel Capacity (litres)

Aux Motor Fitted?

Type of Radio Fitted

Boat Picture - upload a photo of your boat, if you have one

Upload

Trailer Rego

Vehicle Make

Vehicle Colour

Vehicle Rego

Launch Area

Marina Pen Number

Additional Info - anything else that may be relevant

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