Boat Safety Form

If you are a skipper of a boat registered with the club, you will need to complete a boat safety for

NOTE: IT IS THE RESPONSIBILITY OF THE OPERATOR OF THE VESSEL TO ENSURE ITS SAFE OPERATION & SEAWORTHINESS AT ALL TIMES.

Name of Vessel

Rego/Survey Number

First name

Last name

Address

Phone

Type/Make of Vessel

Flybridge

Tower

Colour of Vessel - Hull

Colour of Vessel - Superstructure

Length of Vessel

Metres Beam

Metres Draught

Type of Engine(s) (HP)

Driver Type

Fuel Type

Capacity (L)

Range NM

Number of Life Jackets

Life Raft (Vessels 12m and over)

Life Buoy/Rescue Quoit (Vessels 8m and over)

Bucket and Lanyard

Number of Flares

Expiry Date

EPIRB Type

Expiry Date

Fire Extinguishers Charged and Checked

Number of Bilge Pumps (Manual, Engine Driven, Electrical)

Number of Sand Anchors

Number of Reef Anchors

Number of Sea Anchors

Compass

V Sheet

Torch

Water Supply L

Food Supply Onboard

Number of Days of Food

Radios and Frequency Onboard (2Mhz SSB, 27 Mhz, VHF)

Insurance Details

Insurer

Policy Number

Expiry Date

Skipper's Boat Licence Number

Expiry Date

Boat Owner/Skipper Signature

Date