OUTC PLB Hire Form
Please fill in all fields.

NOTE: THIS FORM WILL ONLY BE REFERRED TO IF PLB IS ACTIVATED. PLEASE ALSO LEAVE YOUR INTENTIONS WITH A TRUSTED PERSON
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Email *
Start Date: *
MM
/
DD
/
YYYY
Finish Date: *
MM
/
DD
/
YYYY
Trip leader: *
Trip leader phone number: *
Trip leader email: *
Be aware this is case-sensitive! Make sure this is recorded correctly.
Trip destination: *
Full names of trip members: *
Panic date: *
MM
/
DD
/
YYYY
Time
:
PLB Number: *
Emergency contact name:   *
Emergency contact phone number: *
Emergency contact email address: *
Be aware this is case-sensitive! Make sure this is recorded correctly.
Vehicle parked at: *
Vehicle Make, Model, and Rego: *
Brief Route Intention: *
Other Useful Information
Anything your rescuers really should know!
Submit
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