Marina Slip Renewal Application FormSLIP / MOORING RENEWAL APPLICATION FOR THE GUILFORD TOWN MARINA Please fill out this form and you will be taken to secure on-line payment & credit card processing via PayPal. If you wish to pay by mail please download the PDF, print it out and send in your check for for the current fee structure. The prices in this form reflect a 3% price increase for the convenience of processing your payments securely on-line. - Thank youName* First Last Phone*(###)###-####Home Phone*(###)###-####Cell Phone*(###)###-####Address* Street Address City State / Province / Region ZIP / Postal Code Email* Please select* RESIDENT TAXPAYER NON-RESIDENTSAFE BOATERS CERTIFICATE NUMBER*COMMERCIAL STATE TAX EXEMPT NUMBERLIABILITY INSURANCE COMPANY*POLICY NUMBER*AMOUNT ($300,000 MINIMUM)*EXPIRATION DATE*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Boat InformationPlease choose from:*POWERSAILVESSEL NAME:MAKE*MODEL*YEAR*CT REGISTRATION NUMBER:*EXACT LENGTH:*INCLUDING ALL EXTENSIO NS, E.G. PLATFORMS, PULPITS, DRIVES, PROPS, ETC.)BEAM:*DRAFT:*ENGINE: HP*Please choose engine:*INBOARDOUTBOARDI/OSEADRIVENumber of Batteries:*FUEL:*GASDIESELFUEL CAPACITY (gallons):*SANITATION DEVICE:*NONEPORTABLE HOLDING TANK TYPE IPORTABLE TYPE IIPORTABLE TYPE IIIWASTE HOLDING TANK CAPACITY (gallons)*SHORE POWER TO BE USED?*YesNoWHEELCHAIR ACCESS REQUIRED?*YesNoSlip Renewal Fees*Class 1 - $1,098.00Class 2 - $1,492.50Class 3 - $1,956.00River Mooring - $989.00Commercial Bulkhead Fee Price: $57.00 Quantity: Commercial Bulkhead = $57.00 per foot. (Please enter the number for feet in the quantity field)Important InformationI (we) hereby certify that this boat is owned by me (us), that the information given by me (us) in this application is complete and accurate and that any misrepre sentation by me (us) is cause for forfeiture of mooring privileges and priorities and/or additional fees. I (we) hereby grant permission to the Marina Staff to board my (our) boat for measurement, security or othe r purposes in compliance with the Marina Rules and Regulations. I (we) hereby agree that the Town of Gu ilford and the Marina Commission shall in no way be held responsible by me (us) or my (our) agents for any claims for compensation for personal injury, bodily injury, property damage and death to me (us), my (our ) craft or its equipment due to storm, cold, ice, fire, sinking, neglect, vandalism, collision or any othe r cause, even if caused by the negligence of the Town of Guilford, the Guilford Marina Commission, its emplo yees, agents, board members or assigns. I (we) agree to hold the Town of Guilford and the Guilford Mari na Commission, its employees, agents, board members or assigns harmless from any and all claims which may be asserted against either or both of them because of any personal injury, bodily injury, property dama ge and death, or loss or damage to or by my (our) craft. I (we) have read the Marina Rules and Regulations r egarding the use of Town boating and parking facili ties and the Guilford Town Marina Severe Weather Plan and I (we) agree to observe and be bound by them, to include renewing registration and insurance as required to maintain compliance with the rules. (NOTE: A signature is required for each person listed on the vessel’s Connecticut State Registration.)Signature* (NOTE: A signature is required for each person listed on the vessel’s Connecticut State Registration.)Date*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Signature #2 (NOTE: A signature is required for each person listed on the vessel’s Connecticut State Registration.)DateMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Total $0.00