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Destination
Known Hazards
Launch Point
Return Point
Departure Date
MM slash DD slash YYYY
Return Date
MM slash DD slash YYYY
Departure Time
Hours
:
Minutes
AM
PM
AM/PM
Return Time
Hours
:
Minutes
AM
PM
AM/PM
Emergency Contact
Emergency Contact Name
Emergency Contact Relationship
Emergency Contact Phone
Are they aware of your plans?
Yes
No
Participants
Name 1
Age 1
Phone 1
Sex 1
Name 2
Age 2
Phone 2
Sex 2
Name 3
Age 3
Phone 3
Sex 3
Name 4
Age 4
Phone 4
Sex 4
Name 5
Age 5
Phone 5
Sex 5
Name 6
Age 6
Phone 6
Sex 6
Name 7
Age 7
Phone 7
Sex 7
Name 8
Age 8
Phone 8
Sex 8
Name 9
Age 9
Phone 9
Sex 9
Name 10
Age 10
Phone 10
Sex 10
Vehicles
Make 1
Model 1
Color 1
Plate 1
Make 2
Model 2
Color 2
Plate 2
Make 3
Model 3
Color 3
Plate 3
Make 4
Model 4
Color 4
Plate 4
Parking
Parking for Launch Site
Backup Parking Plan
Boats on Water
Boats
Not used
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
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23
25
GPS
Not used
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
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23
25
Boats_2
Not used
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
23
25
GPS_2
Not used
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
23
25
Boats_3
Not used
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
23
25
GPS_3
Not used
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
23
25
Boats_4
Not used
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
23
25
GPS_4
Not used
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
23
25
Boats_5
Not used
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
23
25
GPS_5
Not used
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
23
25
Boats_6
Not used
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
23
25
GPS_6
Not used
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
23
25
Boats_7
Not used
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
23
25
GPS_7
Not used
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
23
25
Boats_8
Not used
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
23
25
GPS_8
Not used
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
23
25
Boats_9
Not used
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
23
25
GPS_9
Not used
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
23
25
Boats_10
Not used
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
23
25
GPS_10
Not used
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
23
25
Emergency Equipment/Medication(s)
ALL participants received a safety demonstration
Yes
ALL participants are comfortable with the equipment and understand its operation
Yes
ALL participants have received a properly fitting PFD “life-jacket” and will comply with all laws and regulations regarding use
Yes
ALL questions were answered prior to launch
Yes
Printed Name
Signature
Date
MM slash DD slash YYYY
