$0.00
Spouses Name (optional)Spouses Name or N/A
Street Address *street Address
Suburb *Suburb
Postcode *Postcode
Phone Number *Preferred Contact Number
Email Address (Preferred) *Email Address (Preferred)
Email Address (Secondary) (optional) (optional)
Members RMDL Licence Number *Members RMDL Licence Number
Boat Make/Manufacturer *Boat Make/Manufacturer
Boat Model/Size *Boat Model and size as per registration papers
Boat Registration Number *Boat Registration as per registration papers.
Boat Colour(S) *Colour(s) of Boat. Primary/Secondary
Inboard/Outboard/Sterndrive/Jet *Motor and drive configeration
Boat registration expiry date *Must be current registration expiry date
Current Insurance Provider *Current Insurance Provider
Current Insurance Policy Number *Must Be current policy number
Current Insurance Policy Expiry Date *Must be expiry date of current insurance policy
Child 1 for WAWA insurance (optional)Child first and last name for WAWA insurance purposes. Optional
Child 2 for WAWA insurance (optional)Child first and last name for WAWA insurance purposes. Optional
Child Name 3 for WAWA purposes (optional)Child first and last name for WAWA insurance purposes. Optional
Child Name 4 for WAWA purposes (optional)Child first and last name for WAWA insurance purposes. Optional
Members Business For advertising (optional)Members Business for Advertising. Optional information
Advertise My Business with club members (optional) YES NO This information will be shared with club members via a contact list that is also optional to join
Share My Basic Information * Yes No Share My Name, Phone, and Boat Make/Model with members in the form of a contact list. Optional
For Life Members Only!!!!
