Middle Sea race Crew Information Submission Form

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*
Place of Birth*
Nationality/Citizenship*
Date of Birth*
DD slash MM slash YYYY
Passport Number*
AIS/PLB beacon number ID
Person to contact in case of Emergency*
Contact details for Emergency Contact*
I have Comprehensive Travel Insurance in place?*
Any underlying health issues?
This information will only be seen by the Skipper