AIS MOB & PLB DECLARATION
GCCM GOLD COAST MACKAY YACHT RACE
Mandatory Form for all entrants:
Yacht Name
*
Owner Name
*
First Name
Last Name
Owner's Email Address
example@example.com
Crew 1 Name (Skipper)
#1 AIS MOB MMSI
#1 PLB HEX ID
Crew 2 Name
#2 AIS MOB MMSI
#2 PLB HEX ID
Crew 3 Name
#3 AIS MOB MMSI
#3 PLB HEX ID
Crew 4 Name
#4 AIS MOB MMSI
#4 PLB HEX ID
Crew 5 Name
#5 AIS MOB MMSI
#5 PLB HEX ID
Crew 6 Name
#6 AIS MOB MMSI
#6 PLB HEX ID
Crew 7 Name
#7 AIS MOB MMSI
#7 PLB HEX ID
Crew 8 Name
#8 AIS MOB MMSI
#8 PLB HEX ID
Crew 9 Name
#9 AIS MOB MMSI
#9 PLB HEX ID
Crew 10 Name
#10 AIS MOB MMSI
#10 PLB HEX ID
Crew 11 Name
#11 AIS MOB MMSI
#11 PLB HEX ID
Crew 12 Name
#12 AIS MOB MMSI
#12 PLB HEX ID
Crew 13 Name
#13 AIS MOB MMSI
#13 PLB HEX ID
Crew 14 Name
#14 AIS MOB MMSI
#14 PLB HEX ID
Crew 15 Name
#15 AIS MOB MMSI
#15 PLB HEX ID
Crew 16 Name
#16 AIS MOB MMSI
#16 PLB HEX ID
Crew 17 Name
#17 AIS MOB MMSI
#17 PLB HEX ID
Crew 18 Name
#18 AIS MOB MMSI
#18 PLB HEX ID
Crew 19 Name
#19 AIS MOB MMSI
#19 PLB HEX ID
DECLARATION
Signed by:
*
Owner
Charterer / Skipper
Signature
*
Save
SUBMIT FORM
Should be Empty: