Boat Storage Registration Form

Welcome

First and Last Name *

Street Address *

Town *

Zip Code *

Phone Number *

Email Address *

Are you 16 years or older? *

Yes
No

Are You A Shenipsit Lake Association Member? *

Yes
No

Are You A Connecticut Water Company Employee? *

Yes
No

Are You a Shenipsit Lake Monitor? *

Yes
No

Only boats powered by oars or electric motors are allowed. Sculls, kayaks, paddle boats and sailboats are not eligible because they are more susceptible to tipping over.

Vessel Type *

Hull Material *

Color *

Make *

Model No./Name *

Year Built *

Length *

Does your vessel have an electric motor? *

Yes
No

Boat owners have the option to designate up to two additional boaters to operate their boat in their absence. If you wish to designate an additional boater(s) please complete the information below for each additional boater. Note that additional boaters can be modified throughout the season.

How many additional boaters will be operating your boat in your absence? *

None
1
2

First and Last Name *

Phone *

Email Address *

Is this boater 16 years or older? *

Yes
No

First and Last Name *

Phone *

Email Address *

Is this boater 16 years or older? *

Yes
No