JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
2023 Safety Boat Registration form
Point to La Pointe Official Data Collection for Safety Boat Volunteers.
Date of the Point to La Pointe is Saturday, August 5, 2023
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your answer
Name
*
Your answer
Phone No. (Please provide the best No. on the day of the race.) Enter only Numbers.
*
Your answer
Emergency Contact Name
*
Your answer
Emergency Contact Phone No.
*
Your answer
Mailing Address (Please provide full address including city and zip code.)
*
Your answer
Please provide any medical conditions and/or allergies we need to be aware of. Please include anything that could affect your ability to operate or provide assistance during the swim.
Your answer
T-Shirt Size
*
Small
Medium
Large
X-Large
XX-Large
XXX-Large
Do you have access to a VHF Radio during the race?
*
Yes
No
Required
Type and length of boat
*
Your answer
Training (Check all that apply)
*
BLS (Basic Life Support Certification) Past or Present
EMT (Emergency Medical Technician) Past or Present
WFR (Wilderness First Responder) Past or Present
RN (Registered Nurse) Past or Present
CPR/First Aid
Lifeguard
CNA (Certified Nurse Assistant) Past or Present
Fireman
US Coast Guard
Other:
Required
Have you participated in this event in the past? If yes, in what capacity?
*
Your answer
Please list the name and phone number and emergency contact no. for the crew that will be with you. Every boat needs at a minimum two individuals, one to captain the boat, and one to be a spotter.
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Recreation and Fitness Resources.
Report Abuse
Forms
