Download Boat Storage Application

Boat/Camper Storage Application 2011 - 2012

Personal

Name_____________________________________________________

Address___________________________________________________

Phone Number______________________________________________

Boat Information

Make__________________________Model_________________________

Type of Craft__________________________________Color_________________

Length__________

State Registration #_______________________________

Insurance Company_______________________________

Please Include With Your Application:

1. Killdeer Island Club Members--$100.00 Non-Members $200.00

2.Copy of Your Boat Registration and Insurance Binder (all must be current)

Signature__________________________Date________________________

Terms & Conditions

1. Storage Fee Must be Prepaid. Checks made payable to Killdeer Island Club Inc.
2. This is for storage only. Work on boat/campers will not be allowed.
3. The period for storage is from October 1, 2010 to April 30, 2011. All crafts will be removed from Club Property by May 1, 2011 or crafts will be removed at Owners Expense.

WAIVER OF RESPONSIBILITY

The applicant understands and agrees that the boat/camper is stored in an unsecured area and that THE KILLDEER ISLAND CLUB is not liable for any damages to the stored properties caused by fire, wind, snow, theft, vandalism or other causes.

Signature__________________________

Date______________________________

Return to:
Peter Luchina
31 South Shore Road
Webster, MA 01570