Skip to content

FROM SIMPLEDERBY

Cart
Checkout
Derby Information Form
Derby Update Form
Float Plan For The Greg D. Perez Sportfishing Derby
IPN
LoginPress
My account
Process Payment
Sample Page
Shop

Float Plan For The Greg D. Perez Sportfishing Derby

Please enable JavaScript in your browser to complete this form.

DESCRIPTION OF BOAT

Boat Name *

GU Number *

Model *

Engine(s) Type *

Hull Color *

Manufacturer *

Length *

Horsepower *

Quantity Fuel Aboard *

ELECTRONICS/SAFETY EQUIPMENT ABOARD

VHF Radio *

YES
NO

Depth Finder *

YES
NO

Dinghy *

YES
NO

First Aid Kit *

YES
NO

Life Jackets (How Many) *

GPS *

YES
NO

Radar *

YES
NO

Sound Producing Device (Horn) *

Yes
No

Visual Distress Signals (Flares) *

YES
NO

Fire Extinguisher? *

BOAT DETAILS

Name of Boat Operator (Captain) *

Name of Boat Owner *

Phone *

ADDITIONAL PERSONS ABOARD

#1 Name

#2 Name

#3 Name

#4 Name

#5 Name

#1 Age

#2 Age

#3 Age

#4 Age

#5 Age

#1 Phone

#2 Phone

#3 Phone

#4 Phone

#5 Phone

Any medical conditions for the people on board

Any Child Onboard *

YES
NO

DEPARTURE & RETURN

Departure Date / Time *

Date

Time

Return No Later Than (Date & Time) *

Date

Time

Launched From *

GDP Marina
Agat Marina

Marina Home Port *

Scroll to Top