Town of Urbana Boat Launch Order Form

1
Order No.
2
Order Date* This field is required.
Date
Month
Day
Year
3
Customer Name* This field is required.
First Name
Last Name
4
Email* This field is required.
example@example.com
5
Phone Number* This field is required.
Please enter a valid phone number.
6
Resident's Street Address in the Town of Urbana (non-residents leave blank)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
7
Mailing Address for Residents and Non-Residents* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
8
Are you a RESIDENT or NON-RESIDENT* This field is required.A resident is defined as an individual who owns property or resides within the Town of Urbana. Residency will be verified. If your address is not within the Town of Urbana, you will be subject to the non-resident fee. Renters must provide a note from their landlord confirming residency.
Resident Boat Launch-$40
Non-resident-$250
9
Do you already have a boat launch card?* This field is required.If you do not have a boat launch card, there is an additional $20 fee. The same card is used every year that you renew.
Yes
No
10
First 5 numbers of the card
11
Choose if you are paying by check or credit card* This field is required.
Check
Credit Card
12
If you want to pay with a credit card, please type your phone number so we can call you for your information.If you are mailing your check, please mail to Town of Urbana 8014 Pleasant Valley Road Bath, NY 14810
Please enter a valid phone number.
13
RULES FOR BOAT LAUNCH* This field is required. Noncompliance with the following terms will lead to the loss of privileges to use the Boat Launch Site and/or conduct commercial activities at the docks. If you are a short-term rental owner sharing your pass with guests, you are REQUIRED to pay the commercial fee. However, if you are using the boat launch and docks solely for personal use, you may still obtain a resident pass. USE: The person or business entity to which Town permission is granted shall be responsible for proper use of the Town facilities. Residents and non-residents are allowed to receive only one (1) key. If you are obtaining a boat launch pass for the first time, a fee of $20 is required for the initial key. You will retain the same key each year. In the event that you lose your key, a replacement fee of $20 will apply. ON-SITE AT THE BOAT LAUNCH Be ready to launch your boat before backing into the launch area. (i.e. Uncover boat, make sure all equipment is in proper place, etc. After launching your boat, you must move your boat quickly and avoid tying up the launch area. Overnight parking is not permitted at the docks or within the boat launch area. This space will be monitored by Town Officials and their designated representatives. Park vehicle and trailer, use a minimal amount of parking space, so as not to obstruct the flow of other traffic. Boat trailers without tow vehicles attached or tow vehicles without boat trailers attached SHALL NOT be parked in the boat launch area. The launch area is restricted; swimming, sunbathing, water skiing, and loitering are not permitted. Furthermore, ensure that dogs are leashed in the launch area before boarding the boat. No overnight parking of boat trailer with its tow vehicle shall be permitted in the boat launch area. Where to Park: If there is space, you can park in the boat launch area. There is one handicapped parking space available. If the boat launch area is full, then you may park down at the Town’s parking lot across from the condos. The Town of Urbana reserves the right to close the Boat Launch Site whenever deemed necessary. Additionally, this area shall be closed for the following events on the specified dates thereof: (check website to find out exact closure times). Wine Country Antique Boat Show 7/17/26 to 7/19/26 Glen H. Curtiss Museum “Wings and Wheels” 9/18/26 to 9/20/2026 BEHAVIOR Treat Others with Respect at all Times, regardless of differences in opinion, background, or circumstance. Disruptive, harmful, or disrespectful behavior will not be tolerated under any conditions.Zero Tolerance for Harassment or Bullying: Any form of harassment, intimidation, or bullying—whether verbal, physical, or digital—will not be tolerated. Respect Property and Environment: Vandalism, theft, or any deliberate damage to property is strictly forbidden. Compliance with Authority: You must follow all instructions from a police officer, peace officer, lifeguard or any Town Employees. Safety First: Engaging in risky or reckless behaviors that endanger oneself or others is absolutely prohibited. Rules of the Water Water Skiing is prohibited between sunset and sunrise and times of reduced visibility. Boats must stay 100 feet from "diver down" flags. Commercial vessels operating on the lake need to understand insurance, licensing, safety, permits, and environmental rules. Boating speed limit • 45 mph during daylight • 25 mph after sunset until sunrise, and only 5 mph within 200 feet of the shore, rocks, docks, rafts or moored vessels. (The exception to the 5-mph rule is when pulling up or dropping off a water skier.) What Does Commercial Boat Launch Agreement Mean? All individuals operating a business who utilize the boat launch area and/or slips are required to pay the commercial boat launch fee, as stated in the agreement. This fee grants you permission to use the Boat Launch Site and conduct passenger pick-up and drop-off activities at the docks. To continue conducting business at the boat launch and/or docks, you must renew your application, submit Insurance and pay the annual fee. If you are a short-term rental owner sharing your pass with guests, you are REQUIRED to pay the commercial fee. However, if you are using the boat launch and docks solely for personal use, you may still obtain a resident pass. COMPLAINTS If you observe someone not adhering to the rules and wish to inform the Town, you MUST complete a formal complaint form. This form can be found at the Town Clerk’s Office. If an individual receives three or more reports for rule violations, it will be at the Discretions of the Town board to revoke boat launch privileges. PENALTIES FOR ANY OFFENSE: I hereby agree that any violation of this Boat Launch and dock Agreement determined to be valid by the Town Board, shall result in the immediate termination of my privileges hereunder and, furthermore, for any violations in this agreement I hereby agree to pay a sum of TWO HUNDRED DOLLARS ($200.00) to the Town Clerk within TEN (10) days of said violation. I understand and agree that my privileges will not be reinstated or renewed
Clear
Should be Empty: