IBA Memberhip Application Form

Please note *

Summer policies are only applicable to Ionian waters if you require all Greek waters this will be a yearly policy.

Duration comformation: *

Summer

Yearly

Full Name and title:

Nationality:

Full Address:

Phone:

Email:

Type of Membership:*

Private

Commercial

Vessel Registration:

Name of vessel: *

Details of vessel: *

Type:

Make:

Year built:

LOA:

Draught:

Weight incl. engine:

Registration: *

No:

Country registered:

VHF: *

Yes: No:

Engines: *

No of Engines:

Engine type:

Boat insured: *

Yes: Insurer's Name:

No:.

Name of Boat Owner: *

Shared Owners: *

*( if no leave blank)

Skipper: *

Vessel Base: *

Declaration: I confirm this vessel is serviced and maintained in accordance with the manufacture's recommendations. I declare that, to the best of my knowledge and belief, the statements on this application form are true and correct. I understand that I may cancel my application within 7 days of receiving my membership documents when I may request a full refund for any contribution paid, providing I have not called for assistance under the membership scheme. I also understand that thereafter my membership runs for a period of Membership indicated and cannot be cancelled during that time. I agree to the IONIAN BOAT ASSISTANCE Membership Terms and Conditions.

I have read and accept 'The Declaration' and 'Membership Terms & conditions' Please tick this box

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