stayaboard-application-2018

Marina Stay Aboard Application

First Name

Last Name

Home Phone

Work Phone

Mobile Phone

Street Address

Suburb

Zip Code

City

State

Country

Email Address

Emergency Contact Name

Emergency Phone

Vessel Details

Vessel Name

Vessel Type

Owner / Skipper

Radio Call Sign

Vessel Model

Yacht Launch Multihull Charter

Length

Beam

Draft

Measure

Vessel Insured

Insurer

Policy Number

Registration Number

Country Of Registration

Does your vessel have a current Electrical Warrant of Fitness?

Electrical WOF

Is the vessel equipped with a holding tank or sanitary system?

Sanitary System

Sanitary System Details

Is the vessel under New Zealand Survey?
If yes number of people?

NZ Survey

Survey Number

Are there any further details you would like to give to support your application?

Additional Details

Intended Stay Aboard Details

How long do you intend to stay aboard?

Stay Aboard

Maximum number of people wishing to stay aboard?

People Aboard

Full Details of Occupants:

First Name

Last Name

Nationality

Date of birth

Guest / Crew

First Name

Last Name

Nationality

Date of birth

Guest / Crew

First Name

Last Name

Nationality

Date of birth

Guest / Crew

First Name

Last Name

Nationality

Date of birth

Guest / Crew

First Name

Last Name

Nationality

Date of birth

Guest / Crew

Have you lived at any other New Zealand / Australian Marinas?

Lived at Marinas

Lived at Marinas Details

Do you intend to have any pets onboard?

Pets Onboard

Pets Onboard Details

Referees

Tauranga Bridge Marina requires a minimum of two personal referees before we will process Stay Aboard
applications. Please give details including postal addresses (not box numbers) and email addresses.
NOTE: Relatives are not considered independent referees.

Referees Details

Have you ever been convicted of a criminal offence in New Zealand or Australia?

Criminal Offence

Criminal Offence Details

The contents of this form are true and correct.

Agree

Date

I have read the Marina rules and regulations and will abide by them and the laws of New Zealand.

Please attach a copy of your Drivers Licence or Passport as identification