THIS AGREEMENT is made BETWEEN Queenscliff Harbour Pty Ltd, ACN 106 099 889 of 1 Harbour Street, Queenscliff VIC P: (03) 5258 5459 [email protected] (Supplier) And:

Emergency Contact

Vessel Details



I certify that I have a minimum of $10 million public liability insurance for the above vessel and a current certificate of currency is attached below.
Click or drag a file to this area to upload.
PLEASE NOTE: Only JPG, PNG, GIF and PDF files up to 2Mb are allowed.
As the customer I acknowledge that I have completed this scedule to the best of my knowledge and have read and agree to be bound by the Queenscliff Harbour Casual Berthing Terms and Conditions and Harbour Rules, applicable at this date.