Sailing Form – Charter or Racing

PERSONAL DETAILS

Applicant’s Name

Age

Email address

Phone number

Cover Requested
 Basic Racing Open water Other

ITINERARY DETAILS

Travel Dates
from: to:

Name of tour operator

Name of tour

Please provide details of sailing itinerary including maximum distance from shore

VESSEL DETAILS

Name

Owner

Type / model / material

Dimensions of BEAM, DRAFT & TONNAGE

Use
 Pleasure Commercial Bareboat charter Skipper Other

If other, please state

Hull
 Mono Catamaran Trimaran

Rigging
 Masthead Fractional Other

If other, please state

Engine
 Inboard Outboard Other

If other, please state

Fuel
 Gas Diesel Other

If other, please state

Sail Area, if applicable

CREW SAILING EXPERIENCE

Captain's Name

Captain's qualifications

Number of qualified crew

Will you be a crew member or passenger only?

What activities do you intend to perform onboard?

Please detail your sailing / boating experience and qualifications

RACE / REGATTA DETAILS

If participating in an organised event please provide:

Name of event

Event duration / Dates

Please provide details of the race / regatta schedule including whether you will be sailing / racing at night

INSURANCE HISTORY

Have you had any accidents, claims / or losses in connection with any vessel you have owned, sailed or had under your control in the past 5 years?
 Yes No

If yes, please provide details

Have you ever been refused insurance?
 Yes No

If yes, please provide details

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