Permitting, Environment and Regulatory Affairs

Environmental Resources Management

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Boat Registration Form

First Name *

Middle Name

Last Name *

Address *

City *

State *

Zip *

County *

Ex.305 5555555

Day Phone *

Night Phone

Email *

Organization

Boat Size (ft) *

Draft/Draw *

Total Carrying Capacity * (look on boat's placard for carrying capacity)

Are you bringing a first mate?

Site Choice 1*
Site Choice 2*

I can bring *

adult life vests and
child life vests with me to Bay Cleanup Day.

Captain's T-shirt Size * (choose either a long sleeve or short sleeve t-shirt)
Long Sleeve	M L XL XXL
Short Sleeve	S M L XL XXL

1st Mate's T-shirt Size * (choose either a long sleeve or short sleeve t-shirt)
Long Sleeve	M L XL XXL
Short Sleeve	S M L XL XXL

T-shirt size subject to availability.

Where did you hear about this event?*

I have read this Disclaimer *

Miami-Dade County is a public entity subject to Chapter 119 of the Florida Statutes concerning public records. Your registration information is covered under this law and thus subject to disclosure. All information received is captured and kept as a public record. By checking this box you are acknowledging that the information you are submitting may be shared as part of a public records inquiry.

* denotes that these fields are required.

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