Marina Berth Enquiry

Please note that this is an enquiry form. We will contact you to confirm if we have availability for your vessel on your requested dates.

Part A - Applicant

First Name

Last Name

Phone

Address

The Club must be notified of any change of address or telephone number within seven days

Drivers Licence Number

State

Non Australian Citizens must provide passport identification.

Passport Nationality

Passport Number

Part B - Vessel

Vessel Name

Vessel Type

Overall Vessel Length

Overall Vessel length is the maximum measurement from the forward extremity to the after extremity, including all protrusions and overhangs (LOA).

Place of Registration

Registration Number

Part C - Berthing Requirements

Berthing Type

Living Aboard

Arrival Date

Departure Date

Part D - Insurance

All vessels must have current comprehensive & public liability insurance. NOTE: The insurance policy must be issued by an agency or underwriting agent that is licensed to operate in Australia under the Australian Prudential Regulation Authority (APRA).

Insurer

Policy Number

Expiry Date

Declaration

I, the applicant, certify that the information provided and statements made by me are true and correct; and I acknowledge the Marina Management Protocol and the Rental Conditions and agree to be bound by these. I agree to pay all monies due in accordance with the schedule of fees, set by the club.

I have read and agree with the terms above.