EmailMe Form - LBTD Motorboat Registration Form 3/6/2021

Boat Owner's Name *

First Last

Property Owner's Name *

First Last

Is the boat registered to the property owner, or yearly renter? *

Boat is homeowner's

Boat is yearly renter's

Lake Bunggee Street Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone *

### - ### - ####

Email *

Primary Address (if different from LBTD address)

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Boat Registration (State, Number and Year) *

Boat Information (Type, Make, Color, Length, HP of motor.) All details are required to process applications *

Propulsion *

When not in use, where is the boat stored? *

Moored at dock at property owner's site

Off water on property owner's land

Outside of Lake Bunggee district

Do you already have an LBTD sticker on your boat? If so, what is the number? *

If you launch the boat yourself, please provide all trailer registration details (State and Plate #) *

Terms and Conditions: I certify that I have read and agree to abide by the LBTD Rules and Regulations regarding boats and access to the lake. I also certify that I have a valid Safe Boating Certificate and that I am familiar with and agree to abide by all state laws pertaining to the operation of a powered boat on Connecticut waters. Additionally, that I will not allow anyone who does not have a valid Safe Boating Certificate to operate the above boat on Lake Bunggee, and that I will be certain anyone who does operate this boat follows all pertinent state laws, and Lake Bunngee Rules and Regulations. *

I confirm that I have read and agree to the terms and conditions

PLEASE NOTE::: You MUST also email or mail a picture or digital copy of your boat registration and Boating Certificate to LakesandBeaches@lakebunggee.org for this application to be processed.