NAME_____________________________________________ AGE______________
HOME ADDRESS___________________________________________________________________________
CITY, STATE, ZIP___________________________________________________________________________
PHONE (H)_______________________________ (O) ____________________________________________
YACHT REQUESTED______________________________ OCCUPATION_____________________________
DATE REQUESTED___________________________________
In an effort to maintain our owner's yachts in quality condition and offer quality equipment on board, and to assure the safety of our clients, we ask you to please complete the following form to qualify yourself to operate the vessel you wish to charter.
1) Are you a United States Citizen? Y____ N_____ If no, are any of your crew members? Y____ N_____ If yes, please write: Name_______________________________ Age____________ of crew member.
2) How many years have you been sailing/cruising?________________
3) Do you own or have you owned a boat? Y_____ N____ If yes, how many years?_____________ What types/sizes?___________________________________________________________________________
4) Have you previously chartered before as skipper? Y____ N____ If yes, please complete the following: Boat type/size______________________________________ Dates of Charter ____________to____________ Area where cruised_________________________________________________________________________ Charter Company_________________________________________ Ph No. ___________________________
Boat type/size______________________________________ Dates of Charter ____________to____________ Area where cruised_________________________________________________________________________ Charter Company_________________________________________ Ph No. ___________________________
5) Have you ever cruised the Florida Keys?_____________________ The Bahamas Islands?___________________ If yes, were you captain or crew? ___________________________
6) Have you ever crossed the Gulfstream? _________________ The Bahamas Bank? _________________________
7) List all sailing and navigational experience - are you familiar with coastal and ocean navigation, with the use of charts compass, parallel rules and the use of on board electronics? Please explain: ________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________
8) List any Yacht Club membership or boating courses completed. ________________________________________ _________________________________________________________________________________________
9) Have you had any marine insurance claims in the past three (3) years? Y ____ N ____ If yes, please explain: _____ ________________________________________________________________________________________
10) What is your expected itinerary for this charter ( be as precise as possible ). ______________________________ _______________________________________________________________________________________ _______________________________________________________________________________________
11) In case of emergency we should notify: Name: _________________________________________________ Phone No: _______________________________ Relationship: ______________________________________
12) Please list two personal boating references ( other than family and crew members ): Name Address Daytime Phone ________________________________________________________________________________________ ________________________________________________________________________________________
13) How many guests will be in your charter party? __________________
14) Crew List - Please list all members of your charter party: Name Address Daytime Phone 1) ______________________________________________________________________________________ 2) ______________________________________________________________________________________ 3) ______________________________________________________________________________________ 4) ______________________________________________________________________________________ 5) ______________________________________________________________________________________ 6) ______________________________________________________________________________________
Note: We reserve the right upon boarding to require you to hire a licensed captain to operate the vessel should you not be approved for all aspects of operation and navigation of the vessel.
________________________________________________________ ________________________ Signature of Charterer Date