Crewmember’s Questionnaire for STS Pogoria voyage

(only for participants with confirmation)

tlo-form
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Indicates required field

CONFIRM YOUR BOOKING WITH THE ORGANIZER BEFORE SENDING THIS FORM!
Submitting this form without the previous confirmation is NOT EQUIVALENT with booking the spot on the voyage.


Application for a voyage
Rejs Nr:   /
Termin:      -  
Trasa:     

Crewmember’s Info
wiek lat
Contact Information
Contact
Document
Safety/Emergency contact
Emergency contact
Are you of age (>18 years old)?
An adult
PARENTS / LEGAL GUARDIANS STATEMENT

* required for underaged participant

Niniejszym wyrażam zgodę na udział w rejsie na żaglowcu STS „Pogoria” mojej córki /mojego syna:

PARENTS / LEGAL GUARDIANS CONTACT INFORMATION
  • Address where the guardians might be reached during the voyage
  • Telephone under which the guardians might be reached during the voyage
  • Additional information regarding the participant (health, prescription drugs etc.)

This is the information only for the Office and the ship’s master – treated as confidential data!

YES – I consent to my daughter/son participation in the voyage on STS Pogoria

In case of any doubts or questions, please contact the STAP Office from Mon to Fri from 1000 to 1600

via e-mail: rejsy@pogoria.pl or by telephone: +48-58-620-62-26.