CANOE DESCRIPTION |
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Make Model Color | |||||||||
Type: | Solo | Tandem | Fiberglass | Plastic | Kevlar | Royalex | Cedar |
TENT DESCRIPTION |
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Make Model Color |
VEHICLE DESCRIPTIONTruck or Car |
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Make Model Color | |
Prov/State License Plate # | |
Where Parked |
TRIP DETAILS |
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Park or Area | |
Route | By route, river(s) or lake(s). List in order of Travel. |
Put-in | Place:Time and Date: |
Expected Take-out | Place:Time and Date: |
LeeWay | Rough travel or bad weather cause delays. How many days leeway before calling authorities |
Other Pertinent Details | |
Cell Phone Number | |
Satellite Phone | GlobalStar or Iridium Complete Phone Number: |
PLB | NO YES (Registered with which Authority) |
Radio | VHF channel 16 HF 2182 UHF 121.5(receive only or two-way) CB |
First Aid Kit | Basic or Advanced |
INDIVIDUAL DATAEach member to fill out |
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Name | |
Physical Description | Age:
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Existing Medical Conditions | |
Medications | |
Allergies | Epi-Pen Carried: Yes No |
First Emergency Contact | Relationship: Day Phone: Evening Phone |
Second Emergency Contact | Relationship: Day Phone: Evening Phone |
Other Pertinent Details |
USEFUL PHONE NUMBERS |
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Local Police: | |
Provincial Police or State Troopers: | |
Park Service: | |
Local SAR | |
Expeditor | Company Name:
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