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It is mandatory to complete this manifest in its entirety and return it to us upon sign-in. It is important that we know who is on your boat in case of an emergency.

Please complete each section for every person that will be on the houseboat, you must include their full name, emergency contact name and phone number for the emergency contact.

First Houseboater's Name

First Name*

Middle Name

Last Name*

Phone*
First Houseboater's Date of Birth*
First Houseboater's Information

Vacation Start Date *

Total Number of Passengers *
First Houseboater's Signature*
Second Houseboater's Name

First Name*

Middle Name

Last Name*
Second Houseboater's Date of Birth*
Second Houseboater's Information

Vacation Start Date *

Total Number of Passengers *
Third Houseboater's Name

First Name*

Middle Name

Last Name*
Third Houseboater's Date of Birth*
Third Houseboater's Information

Vacation Start Date *

Total Number of Passengers *
Fourth Houseboater's Name

First Name*

Middle Name

Last Name*
Fourth Houseboater's Date of Birth*
Fourth Houseboater's Information

Vacation Start Date *

Total Number of Passengers *
Fifth Houseboater's Name

First Name*

Middle Name

Last Name*
Fifth Houseboater's Date of Birth*
Fifth Houseboater's Information

Vacation Start Date *

Total Number of Passengers *
Sixth Houseboater's Name

First Name*

Middle Name

Last Name*
Sixth Houseboater's Date of Birth*
Sixth Houseboater's Information

Vacation Start Date *

Total Number of Passengers *
Seventh Houseboater's Name

First Name*

Middle Name

Last Name*
Seventh Houseboater's Date of Birth*
Seventh Houseboater's Information

Vacation Start Date *

Total Number of Passengers *
Eighth Houseboater's Name

First Name*

Middle Name

Last Name*
Eighth Houseboater's Date of Birth*
Eighth Houseboater's Information

Vacation Start Date *

Total Number of Passengers *
Ninth Houseboater's Name

First Name*

Middle Name

Last Name*
Ninth Houseboater's Date of Birth*
Ninth Houseboater's Information

Vacation Start Date *

Total Number of Passengers *
Tenth Houseboater's Name

First Name*

Middle Name

Last Name*
Tenth Houseboater's Date of Birth*
Tenth Houseboater's Information

Vacation Start Date *

Total Number of Passengers *
Parent or Guardian's Email Address

Email*

Confirm Email*
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Guest 1

Full Name *

Emergency Contact Name *

Emergency Contact Phone Number *
Guest 2

Full Name

Emergency Contact Name

Emergency Contact Phone Number
Guest 3

Full Name

Emergency Contact Name

Emergency Contact Phone Number
Guest 4

Full Name

Emergency Contact Name

Emergency Contact Phone Number
Guest 5

Full Name

Emergency Contact Name

Emergency Contact Phone Number
Guest 6

Full Name

Emergency Contact Name

Emergency Contact Phone Number
Guest 7

Full Name

Emergency Contact Name

Emergency Contact Phone Number
Guest 8

Full Name

Emergency Contact Name

Emergency Contact Phone Number
Guest 9

Full Name

Emergency Contact Name

Emergency Contact Phone Number
Guest 10

Full Name

Emergency Contact Name

Emergency Contact Phone Number
Guest 11

Full Name

Emergency Contact Name

Emergency Contact Phone Number
Guest 12

Full Name

Emergency Contact Name

Emergency Contact Phone Number
Guest 13

Full Name

Emergency Contact Name

Emergency Contact Phone Number
Guest 14

Full Name

Emergency Contact Name

Emergency Contact Phone Number
Guest 15

Full Name

Emergency Contact Name

Emergency Contact Phone Number
Guest 14

Full Name

Emergency Contact Name

Emergency Contact Phone Number
Guest 15

Full Name

Emergency Contact Name

Emergency Contact Phone Number
Guest 16

Full Name

Emergency Contact Name

Emergency Contact Phone Number
Guest 17

Full Name

Emergency Contact Name

Emergency Contact Phone Number
Guest 18

Full Name

Emergency Contact Name

Emergency Contact Phone Number
Guest 19

Full Name

Emergency Contact Name

Emergency Contact Phone Number
Guest 20

Full Name

Emergency Contact Name

Emergency Contact Phone Number
Guest 21

Full Name

Emergency Contact Name

Emergency Contact Phone Number
Guest 22

Full Name

Emergency Contact Name

Emergency Contact Phone Number
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Vacation Start Date *

Total Number of Passengers *
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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