Casual Berth Occupancy Agreement

"*" indicates required fields

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This field is for validation purposes and should be left unchanged.

First Name*

Last Name*

Address*

Suburb*

Postcode*

Mobile*

Email Address*

Rego Number*

Boat Length*

Start Date*

End Date*

Name of Insurance Company*

Policy Number*

Expiry Date*

Certificate of Insurance

Max. file size: 2 MB.

Non-Members MUST attach Copy of Certificate of Insurance for above vessel with this application form.

Currently in

Newhaven

16 °

Fine

6^kt

WNW