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					Yachts sailing to Bermuda – Safety and Pre-arrival Questionnaire
Rescue Co-ordination Centre Bermuda / Bermuda Radio / ZBR
Please answer the following questions in order to provide us with important vessel safety information, and to speed
the arrival process at Bermuda.

1.          Vessel Name:

2.          Radio Callsign:

3.          MMSI (9 digit):

4.          Country of Registry:

5.          Homeport:

6.          Official Registration Number:

7.          Length:

8.          Hull Colour and Trim:

9.          Sailing Rig (i.e. Sloop, Ketch, Schooner, etc.):

10.         Draft:

11.         Liferaft Manufacturer and Capacity:

12          EPIRB Type (Check Box):121.5 Mhz Auto        121.5 Mhz Manual    406 Mhz Auto     406 Mhz Manual

13.         406 Mhz EPIRB COSPAS/SARSAT ID (Alphanumeric, 15 characters in length):

14.         Equipment (Check Box):    VHF DSC                      SSB                  AIS

15.         Number of Persons Onboard:

16.         Satellite Telephone Number (if fitted):

17.         E-mail address:

18.         Last Port of Call before arriving Bermuda:

19.         Next Port of Call after departing Bermuda:

20.         Expected Departure date from Last Port of call before Bermuda (Day/Month/Year):

21.         Emergency Contact Ashore – Name and Tel #:

22.         Crew List
Name                                                           Nationality            Date of Birth (Day/Month/Year)




      23.       Remarks (Crew medical conditions, Berthing arrangements in Bermuda, Other)

After completing Information, attempt to close this browser page (X), save changes to document,
and fax (441)297-1530 or email (dutyofficer@marops.bm) saved document.
                             When departing Bermuda, contact Bermuda Radio to
                             confirm your next port of call and the number of POB.
                                    Tel: (441) 297-1010 Fax: (441) 297-1530
                         Inmarsat C : 581 431010110 RCCB X or 584 431010120 RCCB X
     e-mail: mailto:operations@rccbermuda.bmdutyofficer@marops.bm Website : www.rccbermuda.bm
                              SSB : 4,125 kHz and 2,182 kHz VHF : Ch 16 and 27
                                                                                                               01/11/08

				
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