Boat Registration Form

Name of Vessel

Make

Model

Registration

Length

Beam

Hull Colour

Topside Colour

No of Engines

Engine Make

Owners Name

Owners Address

Owners Home Phone

Owners Work Phone

Owners Mobile Phone

Owners Email

Emergeny Contact Name, Mobile

Insurer

Policy Number

Policy Expiry Date

E.P.I.R.B Rego Number

If your vessel is unattended and is in danger, or subject to felony, whom would you like to be notified if you cannot be contacted? Please include a Name, Phone Number, Address and the relationship with the person.