Reservation Form

 

Please fill out the detailed registration form.  The data will be sent to Barrier Free Boating, Inc. to confirm that the calendar date you chose is available.  Remember, the Pilot has to download, read and sign the Pilot Agreement Form and the Pilot History FormThe Boaters Safety Certificate, copy of Valid Drivers License, signed Pilot Agreement Form and the Pilot History Form must be submitted to Barrier Free Boating via email, FAX or US Mail at the same time you reserve the boat.  Once all of the required paperwork is received you will receive an email confirming the date of the reservation. Print this confirmation and when you arrive at the lake, show your confirmation letter and ID to receive the keys to the boat.

Note: * = Required Field

Reservation Form

All information is required for using the Barrier Free Boat.

Reservation Information

All information is required in order to link your calendar date and time with your reservation.

RESERVATION DATE*

START TIME*

END TIME*

RESERVATION NAME OR EVENT TITLE FOR CALENDAR*


Will you need a Pilot*


PILOT / CONTACT INFORMATION

This section is for Pilot/Contact information.

First Name*

 Last Name*

 Address*

 City*

 State*

 ZIP*

 Age*

Phone*

 Email*

Pilot / Contact County*



Are there any disabled persons?*

DISABLED INDIVIDUAL

This section is to be filled out for one disabled representative member of the group.

Diasbled First Name

Disabled Last Name

Disabled Address

Disabled City

Disabled State

Disabled ZIP

Disabled County

Is Disabled Individual a Veteran?

Age

Contact Phone

Contact Email

Disabilty

PASSENGER DATA

This is required information. Maximum Weight Capacity is 2000 lbs

Number of Passengers*

Age Range of Passengers*

GROUP/ORGANIZATION

If applicable, please provide the following. Thanks!

Group/Organization Name

Group/Organization Street Address, City, State & Zip

Group/Organization Phone

Group Representative Name

I have read and agree to Barrier Free Boatings Privavy Policy:

I Agree*


Important Note

Please double check your entries for errors, double check that all entrys identified with a * have been entered and make any changes now before clicking the submit button. Once you click the submit button below, your information will be submitted and you will be automatically redirected to the homepage.

Please enter the phrase above