1.23
ALWAYS FILL THIS SHEET OUT COMPLETELY—IN AN EMERGENCY ALL INFORMATION MAY BE HELPFUL
LARSON CRUISE LOG
Complete this page before going boating and leave it with a reli-
able person who can be depended upon to notify the Coast Guard
or other rescue organization should you not return as scheduled.
Do not file this plan with the Coast Guard.
Name and phone number of person on shore with whom
this form has been filed
_____________________________ _______________
Automobile License ______________________________
Type ___________ Trailer license _________________
Color ___________ and make of auto ______________
Where parked __________________________________
Persons aboard _________________________________
Name
Age
Address & Telephone No.
Captain:
______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
Do any of the persons aboard have a medical problem?
■
■
Yes
■
■
No
If yes, what? ____________________
The boat listed below should return by:
__________________ ________________
at the latest. If it has not, please call the emergency
numbers listed below.
Police
_______________________________
Coast Guard
_______________________________
Other Authority
_______________________________
Personal
_______________________________
Trip Information
_______________________
_______________________
Departure Date/Time
Departure Location
___________________________________________________
Destination(s)
___________________________________________________
Destination(s)
___________________________________________________
Destination(s)
Boat Description
_______________________
_______________________
Boat Name
Type
Larson
_______________________
_______________________
State Registration Number
Manufacturer
_______________________
Length
_______________________
_______________________
Hull Color(s)
Deck Color(s)
_______________________
_______________________
Cabin (Color)
Trim (Color)
____________________________________________________
____________________________________________________
Other Physical Characteristics
Engine
_______________________
_______________________
Type
HP
_______________________
_______________________
Fuel Type
Fuel Capacity
Safety & Emergency Equipment
(YES/NO & NUMBER)
_____________
_____________
______________
Life Jackets
Cushions
Distress Light
_____________
_____________
______________
Flares
Smoke Signals
Flashlight
_____________
_____________
______________
Mirror
Paddles
Anchor
_____________
_____________
______________
Food
Water
Life Raft
Radio
_______________________
_______________________
On board (Yes/No)
Type
____________________________________________________
____________________________________________________
Frequencies usually used or monitored
Passenger List
(Use Another Sheet If Necessary)
____________________________________________________
Full Name
_______________________
________________________
Age/Sex
Phone Number
____________________________________________________
Complete Address
____________________________________________________
____________________________________________________
Full Name
_______________________
________________________
Age/Sex
Phone Number
____________________________________________________
Complete Address
____________________________________________________
____________________________________________________
Full Name
_______________________
________________________
Age/Sex
Phone Number
____________________________________________________
Complete Address
____________________________________________________
____________________________________________________
Full Name
_______________________
________________________
Age/Sex
Phone Number
____________________________________________________
Complete Address
____________________________________________________
Time
Date
1.23
ALW
AYS FILL THIS SHEET OUT COMPLETEL
Y—IN AN EMERGENCY ALL INFORMATION MA
Y BE HELPFUL
LARSON CRUISE LOG
Complete this page before going boating and leave it with a reli-
able person who can be depended upon to notify the Coast Guard
or other rescue organization should you not return as scheduled.
Do not file this plan with the Coast Guard.
Name and phone number of person on shore with whom
this form has been filed
_____________________________ _______________
Automobile License ______________________________
Type ___________Trailer
license _________________
Color ___________
and make of auto
______________
Where parked
__________________________________
Persons aboard _________________________________
Name
Age
Address & Telephone No.
Captain:
______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
Do any of the persons aboard have a medical problem?
■ ■
Yes
■ ■
No
If yes, what?____________________
The boat listed below should return by:
__________________ ________________
at the latest. If
it
has not, please call the emergency
numbers listed below.
Police
_______________________________
Coast Guard
_______________________________
Other Authority
_______________________________
Personal
_______________________________
Trip Inf
ormation
_______________________
_______________________
Departure Date/Time
Departure Location
___________________________________________________
Destination(s)
___________________________________________________
Destination(s)
___________________________________________________
Destination(s)
Boat Description
_______________________
_______________________
Boat Name
Type
Larson
_______________________
_______________________
State Registration Number
Manufacturer
_______________________
Length
_______________________
_______________________
Hull Color(s)
Deck Color(s)
_______________________
_______________________
Cabin (Color)
Trim (Color)
____________________________________________________
____________________________________________________
Other Physical Characteristics
Engine
_______________________
_______________________
Type
HP
_______________________
_______________________
Fuel Type
Fuel Capacity
Safety & Emer
genc
y Equipment
(YES/NO & NUMBER)
_____________
_____________
______________
Life Jackets
Cushions
Distress Light
_____________
_____________
______________
Flares
Smoke Signals
Flashlight
_____________
_____________
______________
Mirror
Paddles
Anchor
_____________
_____________
______________
Food
Water
Life Raft
Radio
_______________________
_______________________
On board (Yes/No)
Type
____________________________________________________
____________________________________________________
Frequencies usually used or monitored
Passeng
er List
(Use Another Sheet If Necessary)
____________________________________________________
Full Name
_______________________
________________________
Age/Sex
Phone Number
____________________________________________________
Complete Address
____________________________________________________
____________________________________________________
Full Name
_______________________
________________________
Age/Sex
Phone Number
____________________________________________________
Complete Address
____________________________________________________
____________________________________________________
Full Name
_______________________
________________________
Age/Sex
Phone Number
____________________________________________________
Complete Address
____________________________________________________
____________________________________________________
Full Name
_______________________
________________________
Age/Sex
Phone Number
____________________________________________________
Complete Address
____________________________________________________
Time
Date