NAVILOC

PORT DE PLAISANCE DES SABLONS

B.P  104 – 35403 SAINT-MALO Cedex

SKIPPER :

 

Name :.................................................... First Name :......................................Date of birth :............................

 

Occupation :........................................................................................ Nationality :........................... 

 

Address :...................................................................................................................................................

 

Zip Code :..............................Town :........................................................... Country : ...........................

 

Private Phone Number. :..............................Office Phone Number.:.......................................................

 

Portable :..................           ........................@ :................................................................

 

Number of years of sailing practise : ..............................................................................................

 

Types of yacht you have been sailing on : ......................................................................................

 

      as skipper :...........................................................................................................................

 

      as crew member :.................................................................................................................

 

Aeras where you have been sailing :...............................................................................................

 

Your sailing program over this period :...........................................................................................

 

Number of crew members (excluding yourself) will be of : ...........................................................

 

 I undersign , M................................................................., designated skipper of this charter, declare

being capable to assume the responsability of the crew and the yacht.

 

 

Place...................................................              Date ...........................................

 

Signature :                             Skipper Signature :

 

 

·                 I am interested in receiving information on :

 

      [ ] Gestion -Renting

      [ ] Buying a yacht         [ ] New          [ ] with gestion

                      [ ] Second Hand      [ ] without gestion

 

* For our statistics, thanks to let us know how you :

[ ] "BATEAUX" Magazine

[ ]"VOILES ET VOILIERS"Magzine

[ ] "VOILE MAGAZINE"

[ ] Boat Show

[ ] Internet

[ ] Direct in our office

[ ] Minitel

[ ] Others (friends….)

 

English Version