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| Prefix |
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| First |
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| Last |
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| Billing Address |
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| City |
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| State |
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Zip
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| Daytime Phone |
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| Evening Phone |
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| Location of Boat |
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| Boat Length |
ft. |
Beam
ft. |
| Boat has trailer |
 Yes
No |
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| If boat is on trailer, length of boat plus trailer | ||
| Engine |
Gas
Diesel |
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Inboard
Outboard
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| If outboard, will you be storing the outboard with us? |
Yes
No
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| Begin Storage Date |
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| End Storage Date |
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| Boat is insured |
Yes
No
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| Name of Insurance Carrier |
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Deposit of $75.00 must be received within seven working days to hold space. Check should be made payable to: IndoorBoatStorage. Mail to: IndoorBoatStorage, 95 Walsh Way, Denton, MD 21629 |
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