EAST COAST BOAT RACING CLUB OF N.J.
CHECK-IN LIST
DATE:________ RACE SITE LOCATION:______________________________
TIME BOAT ARRIVED AT SITE:______________________________________
CLASS:____________ BOAT #:__________________
BOAT NAME:_____________________________________________________
LIFE JACKETS:__________________ HELMETS:_________________
SHAFT:_________________________ PROP:______________________
RUDDER:_______________________ PLATE:____________________
STEERING CABLE:_______________ BATTERY BOX:_____________
MOTOR MOUNTS: ________________ FLYWHEEL COVER:__________
DRIVE SHAFT:___________________ KILL SWITCH:________________
FIRE EXTINGUISHER: _____________ INTAKE BOLTS SEALED:_______
ENGINE SEALED & DATED: ________
OTHER/ MISC:_____________________________________________________
INSPECTED BY:____________________________________________________
PLEASE PRINT DRIVER NAME:________________________________________
DRIVER SIGNATURE:_______________________________________________
PLEASE PRINTCO-PILOT NAME:_______________________________________
CO-PILOT SIGNATURE: _____________________________________________
NOTE: DRIVER & CO-PILOT MUST BE THE PERSONS IN THE BOAT THAT DAY!
NOTES/COMMENTS:_________________________________________________
___________________________________________________________________
EAST COAST BOAT RACING CLUB OF N.J.
EMERGENCY MEDICAL INFORMATION
DATE:________
NAME:____________________________________
D.O.B.:____________
BOAT NAME:______________ # ___________
CLASS:______________________
ADDRESS:_______________________________________________________
_______________________________________________________
PHONE #:____________________
ALTERNATE PHONE #:____________________
DOCTOR(S) NAME:____________________________________________________
ADDRESS:
___________________________________________________________
PHONE #:______________________
EMERGENCY CONTACT PERSON:
______________________________________
ADDRESS:___________________________________________________________
PHONE #:____________________________
ALLERGIES TO MEDICATIONS:_______________________________________
MEDICAL CONDITIONS:______________________________________________
______________________________________________
I AM PRESENTLY TAKING THE FOLLOWING MEDICATIONS:
1. __________________________________________________
2. __________________________________________________
3. __________________________________________________
4. __________________________________________________
5. __________________________________________________
6. __________________________________________________
HOSPITAL PREFERENCE: SOCH ( )
COMMUNITY MED. CTR. ( )
NO PREFERENCE ( )
