Crew Information Submission Form (Adventure leg 1)

The following information is required under Maritime law and will be submitted to the charter company and the Coastguard. Please populate ALL fields accurately.
Email*

The email address you currently receive emails from Sailing the Med
First Name*
Last Name*
Address*
Town/City*
Country*
City/town of Birth
Nationality/Citizenship*
Date of Birth*
DD slash MM slash YYYY

please enter DD/MM/YYYY format or Use Calendar to select
Passport Number*
Person to contact in case of Emergency
Contact details for Emergency Contact
I have Comprehensive Travel Insurance in place?*