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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 ( ) |