GBN ADULT-Borrowed Boat: Permission to Use

GBN Adult-Borrowed Boat: Permission to Use - Entry Form

Permission to use from boat owner.

Information regarding WLI is available at GBN website in the document entitled "Watercraft Liabilty".

REQUIRED to be completed IF the boating particpant is using a borrowed boat for a tournament.

GBN Adult: ADULT anglers ONLY, for GBN Adult State Classic

Boat Make / Model / Color
Boat Manufacturer Make & Model. ex: Ranger/520 C/red
Engine Make / Model
Engine Manufacturer Model. ex: Mercury/250
GDNR Registration number
Must be valid and active for the current year must begin with State designation

I, the owner of the above referenced boat:

First NameLast Name
Owner e-mail: (example@example.com)
Owner cell phone number
Please enter a valid phone number.Format: (000) 000-0000.
residing at the following address:

Boat owner Street Address

Boat owner Street Address Line 2

CityState

Zip Code

do give my full and complete consent to:

First NameLast Name
To use this Boat on the following start Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
and end on the following Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

Borrower residing at the following address:

Borrower's Street Address

Borrower's Street Address Line 2

CityState

Zip Code
Borrower Email (example@example.com)
**Email copy OPTION: Enter Email address of individual registering your team. This will copy the individual on this submission containing the SUBMISSION ID which is REQUIRED. (example@example.com)
Borrower Cell Phone #
Valid Angler cell phoneFormat: (000) 000-0000.
Club Name
Angler Club name
Club Number
6 digit number, prepend your club # with leading zeros EX: Club# is 123, ENTER 000123; Club# is 10707, ENTER 010707

Boat Owner - Upload the following: 1) boat policy declaration page showing WLI of $300,000 at minimum with active coverage dates AND 2) a letter from your insurance agent stating that [borrower's name] will have $300,000 WLI while using referenced boat. These files can be pdf or text document or scanned copy of the documents (2 are REQUIRED).

File or scan copy
Cancelof

Borrower of Boat - provide my own WLI. Upload a WLI copy (must show coverage availability while using the borrowed boat OR a statement from your insurance agent stating you are covered with $300,000 WLI while using the borrowed boat.

File or scan copy
Cancelof

Boat Owner Signature - GBN reserves the right to contact boat owner at the phone number or email referenced in this form with questions concerning this matter. Please SUBMIT after all info & signatures have been obtained.
Please verify the CAPTCHA and SUBMIT
Should be Empty: