Liverpool Sailing Club

Liverpool Sailing Club

BOAT REGISTRATION FORM

PLEASE COMPLETE (BOTH SIDES) IN BLOCK CAPITALS

And return to: The Sailing Secretary. C/o 231, Brierfield, Skelmersdale, Lancs. WN8 9JD

Page 1 - Boat Details

Boat’s Name______Please also supply a recent photograph.

Sailing Dinghy / Yacht / Powerboat (including RIBs) / PWC / Windsurfer / Canoe / Hovercraft/ Other

(Please delete as applicable)

If “Other” please specify:______

Sail Number (if applicable)______Class (if applicable)______

Hull Registration Number (if applicable)______SSR No. (if applicable)______

Length ______Beam ______Draught______

Builder or Manufacturer (if known)______Engine size______

Colours:

Hull ______Topsides ______Sails ______

Distinguishing Features______

______

SAFETY (delete as required)

VHF Carried ? YES / NO Callsign ______

MMSI No.______

(Please be aware that LSC sets are not all DSC equipped)

Registered under CG66? YES/NO CG66 Registration Number______

Radar Reflector carried? YES/NO

Page 2 - Member & Owner Details, & Insurance Declaration

Member’s Name ______

Address: ______

______

______

Telephone ______Mobile ______

Email______

Owner’s Name and address (if different) ______

______

______

Telephone ______Mobile ______

Email______

INSURANCE DECLARATION:

I declare that the above vessel is insured for third party risks, in a sum of not less than £2,000,000, to cover my use of her on the Mersey. Please note that this is the minimum, and that we recommend a higher limit of at least £3,000,000.

I further declare that I will not allow guests to use the vessel unless their use of it is also covered by this or similar insurance, and that I will maintain the insurance in force for as long as I use this vessel at Liverpool Sailing Club.

Signed (by Member)______

Date ______

Please note that re-registration is not required annually, and need only be done if any details change

DATA PROTECTION NOTICE. All information supplied is for the use of LSC only and will not be passed to any third parties. Names, boat details, callsigns and MMSI numbers will appear in the Club handbook for distribution to members. If you do NOT wish your details to be included please tick the box to opt out.

Additional copies of this form are available at the online LSC Yahoo Group or the LSC website. Alternatively hard copies are available on request from the Sailing Secretary or at the Club.

(Version 2014: updated April 2014)