Which boat do you want to hire?  ................................................................................................

Boat hire date: ...............................    Boat return date:  ........................................   

Skipper’s name   .............................................................................................................

Skipper’s boating experience (type of boat, hours of operation, offshore experience) ........................................................................................................................................................................................................................................................................................................................................................................................................................

Crew names

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Is a LBT skipper required? Note extra costs apply.  ..............................................

Contacts. Next of kin phone numbers and addresses for all on board ................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Medical details (significant medical history of all on board, including allergies and medications)....................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

References from any previous boat use in the case of the Gretchen and Kon Tiki

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$100 deposit, fully refundable if boat returned in same condition as hired out

Either:

Pay by EFTPOS at LBT shed in Franklin

Or

Make Internet Banking Payment to

Bank…….CBA

Branch ….Huonville, TAS 7008

A/c name…The Living Boat Trust

BSB 06 7008

A/c no.  28031138

Please make sure you put your name/boat name as part of the “Reference” and it would assist the Treasurer if you could notify her by email that a remittance has been made (treasurer@lbt.org.au)

Or

Cheque by mail to: The Treasurer,PO Box 79, Franklin, Tasmania, 7013 together with this form duly completed.

Name  ……………………………………… email address………………………………......

Postal address  ……………………………………………….

                        ……………………………………………….

Postcode    .................   Telephone .................................... Mobile...................................

email address .....................................................................................................................