Event registration

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Details

Mooring Enquiry

Date TBA

Yacht Club, 1 King Street, Busselton WA 6280

Are you attending this event?

Yes No Maybe

Basic details

First name*

Last name*

Phone number*

Email address*

Address*

Additional information

Applicant Information

Full Name

GBYC Membership Number*

Phone Number:*

Email Address*

Please fill out all details of your boat.

Vessel Name*

Type of Vessel*

Length Overall (LOA):

Registration Number:*

Vessel Weight:

Insurance Policy Provider and Policy Number:*

Upload Copy of Certificant*

Choose file...

Max 5MB

Please fill out when you would like to use the Mooring

Requested Start Date*

Requested End Date*

Total Duration in Weeks

Reason for Extended Use

Fee

Extended mooring use is subject to a $100 per week fee

How many weeks needed:

I am over 18, or, if I am under 18, this registration has been filled out by and endorsed by my parent or guardian.*

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