Booking Form – Charter If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required Yacht required (Please check availability and provisionally reserve your yacht before completing) Name & Type Period Required From hrs on date from To hrs on date to Intended Cruising Area Charterer/Party Leader Title Mr Mrs Miss First Name * Last Name * Email * Home Tel Day / Office Tel Mobile Phone Address 1 Address 2 Town / City Post Code Country Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua And Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia And Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, The Democratic Republic Of The Cook Islands Costa Rica Cote D'Ivoire Croatia (Local Name: Hrvatska) Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Timor-Leste (East Timor) Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France France, Metropolitan French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard And McDonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran (Islamic Republic Of) Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic Of Korea, Republic Of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macau Macedonia, Former Yugoslav Republic Of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States Of Moldova, Republic Of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Kitts And Nevis Saint Lucia Saint Vincent And The Grenadines Samoa San Marino Sao Tome And Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia (Slovak Republic) Slovenia Solomon Islands Somalia South Africa South Georgia, South Sandwich Islands South Sudan Spain Sri Lanka St. Helena St. Pierre And Miquelon Sudan Suriname Svalbard And Jan Mayen Islands Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic Of Thailand Togo Tokelau Tonga Trinidad And Tobago Tunisia Turkey Turkmenistan Turks And Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Viet Nam Virgin Islands (British) Virgin Islands (U.S.) Wallis And Futuna Islands Western Sahara Yemen Yugoslavia Zambia Zimbabwe Emergency contact Name Tel Charterers Declaration: I have read and understand the Booking Conditions and on behalf of myself and the crew listed on this form and any others who might subsequently be added to the crew agree that this booking is made subject to the Booking Conditions. Check this box if you agree Skippers Details Please attach copies of relevant certificates held. (ICC or Day Skipper Practical is minimum required) Name Passport Number DOB Sailing Qualifications Sailing Experience including details of trips as skipper: Previous Charters as Skipper (state if not Skipper): Yacht Type Company Date Yacht Type Company Date Crew Details (Required for Coastguards, Customs etc) Please enter the details of the first individual you would like to reserve a place for. First Name * Last Name * Date of Birth * Sex * Please Select Male Female Sailing Experience * Please enter the details of any second participant. First Name Last Name Date of Birth Sex Please Select Male Female Sailing Experience Please enter the details of any third participant. First Name Last Name Date of Birth Sex Please Select Male Female Sailing Experience Please enter the details of any fourth participant. First Name Last Name DOB Sex Male Female Option 3 Sailing Experience Please enter the details of any fifth participant. First Name Last Name DOB Sex Male Female Option 3 Sailing Experience Please enter the details of any sixth participant. First Name Last Name DOB Sex Male Female Option 3 Sailing Experience Please enter the details of any seventh participant. First Name Last Name DOB Sex Male Female Option 3 Sailing Experience Payment Details - Please make cheques payable to Moonfleet Sailing Charter Fee £ Outboard Rental £35 /£50 £ Fuel @£5 per day £ Cleaning at end of charter (£35) £ Returnable Security Deposit ( if cheque due 14 days before charter) £1000 Extras £ Total £ A 25% deposit is required to secure your booking. Please contact Moonfleet Sailing at your earliest convenience to arrange payment. Check this box if you agree: * To illustrate that you are a real person, please perform the following simple calculation: 3 + 14 *
