Europa Booking Form
First Name*
Last Name*
Email*
Preferred Name (nick name)
Gender*
Date of Birth *
Address 1*
Address 2
Town/City*
County/Region
Postcode/Zip*
Country
Home Phone*
Work Phone
Mobile Phone
You can book up to three voyages for only one Booking Fee. Vessel to sail on (1)*
Voyage Number (1)*
Start date (1)*
Voyage Fee (1)*
Booking Fee €30.00*
Voyage 2 Vessel to sail on (2)
Voyage Number (2)
Start date (2)
Voyage Fee (2)
Voyage 3 Vessel to sail on (3)
Voyage Number (3)
Start date (3)
Voyage Fee (3)
Other Comments Any other comments?*
Please give emergency contact details. All information is confidential and not used for any other purpose. Name of Next of Kin who will not be sailing with you?*
Next of Kin Address*
Next of Kin E-mail*
Next of Kin telephone number*
Next of Kin relationship to voyage crew*
Your Doctor's or surgery name and telephone number.*
Please answer all these health questions. Do you have any respiratory problems?*
Do you have high cholestrol or use anticouagulants?*
Do you suffer from diabeties?*
If you have diabetes do you need injections?
Are you by experience prone to motion sickness (sea sickness)?*
Do you have epilepsy?*
Do you have an increased risk for infections or did you have radio or chemotherapy in the past 24 months?*
Have you been denied a drivers license on medical grounds?*
Do you use anticoagulants (blood thinners)?*
Are you on any regular medication?*
Have you had any serious illness or accident in the last 5 years?*
If female are you pregnant?
Do you need help climbing stairs or taking thresholds of 60 cm (2 ft)?*
Do you have any heart or vain problems?*
Are there any other medical difficulties that Europa must know about? If so please enter the details below.*
If you answered Yes to any question please give details here.
Are you a vegetarian?*
Please give details of any dietary requirements or enter None*
Please give details of any allergies or enter None*
Your height:*
Your weight*
Passport information is required for all voyages on Europa. Passport Requirements*
Passport No
Passport valid until (At least 6 months beyond voyage end date.)
Nationality?
Town of Birth?
Passport Issued at:*
I declare to have my own travel insurance that covers this voyage.*
I declare to have valid health insurance provided in my home country.*
Entering your Full Name will signify your acceptance of our Terms and Conditions. *
Place signed*
Date Signed*
All information is confidential to Classic Sailing and the vessel being sailed on.
* Indicates field is required.
