When you go on a boating outing you plan as much as possible so that nothing goes wrong. You watch the weather, you carry enough fuel, and you carry spare parts for emergency repairs. But if you were to have an accident, or be stranded with a disabled boat, or if the boat were to sink or be destroyed by fire, would anyone know where you were? Would they even know you were gone? These questions will be answered in your favor if you fill out the attached form and leave it with a responsible family member or friend before you leave.

DATE

NAME

AGE

ADDRESS

Phone #

DESCRIPTION OF BOAT:

MAKE/MODEL

COLOR

NAME

REG. #

LENGTH

OTHER INFO.

PERSONS ABOARD

Age

Address

Phone #

Any medical problems?

ENGINE TYPE

HP

NO. ENG

FUEL

CAPACITY

EQUIPMENT

FLARES

MIRROR

FOOD

WATER

ANCHOR

EPIRB

LIFE JACKETS

FLASHLIGHT

PADDLES

OTHER

RADIO TYPE

FREQUENCIES

ITINERARY

PRIMARY ACTIVITY (fishing, cruising, skiing, etc.)

LEAVING FROM

TIME LEAVING

GOING TO

RETURNING NO LATER THAN

AUTO LICENSE

COLOR/MAKE

WHERE PARKED

TRAILER LICENSE

IF NOT RETURNED BY

CALL U.S. COAST GUARD AT