CHARTERER:   BOAT:  
ADDRESS:   PHONE #:  
FAX #:   EMAIL:  
MASTER/SKIPPER:    
(If different from the Charterer)  

  1. Have you chartered before as Skipper? Yes (   ) No (   )
    1a. Have you chartered before as Crew? Yes (   ) No (   )
    If "Yes", fill in below:

    Year Type & Size of Boat Area Cruised Length of Charter (S)kipper/(C)rew
             
             
             
             
             

  2. Have you owned a boat? Yes (   ) No (   )
    2a. Have you operated a boat as Skipper? Yes (   ) No (   )
    If "Yes", fill in below:

    Type & Size of Boat Period Owned Location Where Operated Year Used # Days per year
             
             
             
             
             

  3. Additional boating experience; type & size of boat; area sailed; whether racing/cruising/day sailing; as Crew or Skipper

    Course Year Completed Size & Type of Boat School Name & Location
           
           
           

  4. List any boating, navigation or related courses you have taken, and when and where completed.

     
     
     
  5. Do you understand Aids to Navigation and Rules of the Road? * Yes (   ) No (   )
  6. Can you read and use charts properly? * Yes (   ) No (   )
  7. Can you read and use tide and current tables? * Yes (   ) No (   )
  8. Can you competently perform proper anchoring procedures in tidal waters? Yes (   ) No (   )
  9. Do you understand proper Man Overboard recovery procedures? Yes (   ) No (   )

  10. Have you had ANY boating accidents? Yes (   ) No (   )

    Please Provide Details:_______________________________________________________

    ________________________________________________________________________________

* Please Note: Upon arrival, you will be required to write a navigation quiz to verify your navigation knowledge.

COMPETENCY - This is to certify that I, the Charterer (Master/Skipper), am experienced and competent in all aspects of the handling and operation of the yacht selected, including practical knowledge of seamanship, navigation, piloting, and the Rules of the Road.

I certify that, to the best of my knowledge, the above is a true representation of my boating background and is given with the intent that it can be relied upon by DESOLATION SOUND YACHT CHARTERS LTD. and their insurance underwriters in approving the application for charter of the vessel.

CHARTERER:   DATE:  
MASTER/SKIPPER:   DATE:  
(If different from the Charterer)  

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