This document is for your benefit. In the event of mechanical difficulties, weather related problems, or other boating hazards, having a plan and the proper equipment to deal with these issues can make a huge difference in the outcome. Fill out this form as completely as possible and leave it with a responsible party (spouse, PIPrincipal Investigator View Boston University's policy on..., Harbor Master) on shore. In the event your return is delayed and communications are lost, this shore party should activate the appropriate response as detailed on this form. It is recommended that you bring a copy with you in the boat, but be sure you leave this form on shore. Name of vessel:*Operator Name:* First Last Operator Telephone Number:*Local Address: Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country BU Principal Investigator: First Last BU Principal Investigator on board?* Yes No Description of VesselType of Vessel:*Color of Vessel:*Color of Vessel Trim:*Registration Number of Vessel:*Length of Vessel:*Sails:*Make of Vessel:*Number of Engines:*Make of Engines:*Horsepower of Engines:*In / Outboard:*Fuel capacity of engines:*Canvas Top?* Yes No Color of Top:*Survival and Safety EquipmentCheck as appropriate.Survival and Safety Equipment* PFDs* Paddles Bell/whistle/horn Working radio* Monitoring Channel Cell phone Day signals Night signals Exposure protection Anchor Amount of line Sea anchor Fire extinguisher* Bailing device Tool kit Compass and charts or maps Check as appropriate. Items marked with an * are required.Number of PFDs:*NotificationShore Contact Name:* First Last Shore Contact Phone Number:*Time to initiate response plan:* : HH MM AM PM If no contact is made with the Shore Contact by this time, the Shore Contact will initiate the response plan detailed in this form. Please make sure to indicate the time using AM or PM.Coast Guard Contact Information:*If no contact is made with the Shore Contact at the time specified above, please provide the appropriate Coast Guard contact information that should be used to initiate the response plan.Local Authority Contact Information:*If no contact is made with the Shore Contact at the time specified above, please provide the appropriate contact information for the local authorities that should be used to initiate the response plan.Planned Activity:*Please detail your planned activities.Trip DetailsTrip Departure Date:* Date Format: MM slash DD slash YYYY Trip Departure Time:* : HH MM AM PM Trip Departing From:*Trip Destination VIA:*Please provide your destination, and specify the route you will be taking.Trip Return Date:* Date Format: MM slash DD slash YYYY Trip Return Time:* : HH MM AM PM Latest Time of Return:* : HH MM AM PM Trip Returning To VIA:*Please provide your return destination, and specify the route you will be taking.Other travel notes:*Forecast:*Source of Forecast:*Tide:*Skies:*Winds:*Are there any current weather advisories?* Yes No List other people on boardNameGenderAgePhone Numer Please provide the name, gender, age, and phone number of each individual on board.CommentsThis field is for validation purposes and should be left unchanged.