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Slip Reservation Form
Vessel Information
Name
Type
Power
Sail
Make
Draft
LOA
Beam
Flag
Registration Number
Insured by
Electrical Requirements
120V(50 amp) Single Fase
240V(50 amp) Single Fase
Other
Please specify electrical requirements:
Are you clearing customs at Itz'ana Marina?
Yes
No
*Do you require a clearing agent?
Yes
No
What is your planned arrival date?
How many days would you like to stay at Itz'ana Marina?
Are you planning to fuel at the Marina?
Yes
No
*How many gallons?
Do you have any special requirements?
General Information
Captain Information
Captain First Name
Captain Last Name
Owner Information
Owner First Name
Owner Last Name
Contact Information
Address
City
Zip Code
Country
Phone
Email
Satellite Phone
Fax
Submit