Application for Boat Slip Rental

Application for Boat Slip Rental

Apply for a boat slip by providing your personal, vessel, and insurance information. All applications are subject to management approval.
Registered Owner Full Name

First NameLast Name
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Home Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Date of Birth

MonthDayYear
Date
Email Address
example@example.com
Employer Name & Address
Work Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
How Long Employed
Bank Name & Address
Lien Holder Name, Address & Phone
Make/Builder (Vessel)
Year (Vessel)
Model (Vessel)
Power or Sail
Length Overall (ft)
Draft (ft)
Beam (ft)
Hull Material
DMV Registration Number
DMV Registration Expiration Date

MonthDayYear
Date
US Coast Guard Documentation Number
USCG Documentation Expiration Date

MonthDayYear
Date
Vessel Insurance Company and Phone
Liability Amount (USD)
Insurance Policy Number
Policy Expiration Date

MonthDayYear
Date
Emergency Contact Name and Phone Number
Vessel Presently Berthed At
Applicant Signature
Applicant Signature Date

MonthDayYear
Date
Approved Date (Office Use Only)

MonthDayYear
Date
Management Signature (Office Use Only)
Should be Empty: