Haul Out Request Form

Wyndham Harbour

Name Of Applicant*
First Last
Name of Vessel Owner (If Not Applicant)
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Emergency Contact Details*
First Last
Phone*
Preferred Haulout Date (No Weekends)*
DD slash MM slash YYYY
Days Out of Water*
How long are you estimating the vessel will be on the hardstand?
Vessel Details
Vessel Name
Vessel Make*
Vessel Model*
Registration*
Year
Fuel
Vessel Length - Overall (LOA)*
Vessel Beam (meters/feet)*
Draft (meters/feet)*
Vessel Weight (tonnes)*
Motor Make
Motor HP
Motor Year
Typer Of Construction (hull)*
Power*
Number Of Engines*
The Vessel Is Fitted With:
- Fire System
- LPG Bottles Onboard
- Sewage Holding Tanks
- Emergency Bilge Alarm
- Security System
Please tick ALL applicable
I confirm that I have a minimum of $10 million public liability insurance for the above vessel and have attached a current certificate of insurance below.*
- Yes
- No
Attach A Current Certificate Of Insurance
Max. file size: 50 MB.
Consent To Terms And Conditions*
All Haul Outs are subject to availability and are weather permitted. By submiting this form, you agree to abide by all marina and hardstand rules and regulations. You agree that all Fees are payable to the marina office prior to re launching the vessel. All Haul Outs will be confirmed via email.

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