Registration Form ‹ PACIFIC POSSE

VESSEL NAME *

WHICH SEASON WILL YOU SAIL OUT

Which season will you set sail across the Pacific. Just to be CLEAR planning for it, is not participating Please only sign up for the season you will set sail. Registration for year 2021 is free !

2023
2024
2025
2026

VESSEL Port, State, Country of Registration *

example San Diego, CA, USA

CAPTAIN First and Last Name *

VESSEL Manufacturer and Model *

VESSEL Year built *

VESSEL Length *

vessel length in feet

Depth

Vessel Depth in Feet

CAPTAIN ACTIVE MOBILE PHONE NUMBER

COUNTRY CODE + MOBILE NUMBER

FIRST MATE FIRST NAME LAST NAME EMAIL

Please provide all Full Names and email addresses for all onboard

BIO of VESSEL, CAPTAIN and CREW

VESSEL HAS THE FOLLOWIN COMMS

PLEASE PROVIDE YOUR MMSI #

PLEASE PROVIDE YOUR VHF RADIO CALLSIGN AND HAM CALLSIGN IF YOU HAVE ONE

VESSEL TRACKER URL

SATELLITE PHONE NUMBER IN CASE OF EMERGENCIES *

VESSEL REGISTRATION NUMBER

UNIQUE HULL ID

WHERE IS YOUR VESSEL NOW

Location of your vessel, Marina, Country, Anchorage etc

WHAT IS YOUR APPROXIMATE FLOAT PLAN

VESSEL SAFETY GEAR ONBOARD

please list all your vessel's safety gear

DO YOU HAVE ANY OTHER QUESTIONS

You are signing up and registering for a big adventure with absolute risks. You and all your crew are all hereby signing complete waivers of liability. YOU AND YOUR CREW COULD DIE OR BE SERIOUSLY INJURED FOR LIFE. YOU AND YOUR CREW MAY BE SHIPWRECKED MAROONED AND LEFT TO DIE. DO YOU AGREE TO ALL TERMS AND CONDITIONS listed under the https://pacificposse/tos ? *

I have read, understood, and fully agree to all the terms and conditions listed under https://pacificposse.com/tos/

YES I AND ALL MY CREW AGREE

SIGNATURE AND DATE *

Please sign and date this Registration

DATE

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