Small Vessels
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| Name: | Phone: |
| Address: | Cell: |
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| Other Numbers:
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| In case of accident or injury, contact: | |
| Name: | Home: |
| Relationship: (spouse/parent…)
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Office: |
| Cell: | |
| Medical Information | |
| Doctor: | List any allergies, medication or medical conditions that a paramedic should be aware of: |
| Tel : | |
| Address:
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| Certificate type | Issued by: | Expiry date |
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Training
On-board orientation and safety training was carried out before beginning any duty on the first voyage:
Signed: ____________________ (Crew member)
____________________ (Person carrying out the training)
Date:____________________
Version 1.0
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