Crewmember’s Questionnaire for STS Pogoria voyage

(only for participants with confirmation)

tlo-form
1 of 3 (0%)
Indicates required field

To begin download the attachment, fill in, sign, scan and have it ready in form of JPG or PDF file. You will be asked to attach the file on page 4 of this form.
IMPORTANT:
You must be at least 14 years old to send the form.
Underage persons (<18) are required to have a written permission from parents or legal guardians.
All the data you will provide on this page is send to a secure folder on an encrypted server without a third party access.

Rejs nr: /
Termin: -
Trasa:
Document

If you are sailing for the first time, enter "0"


Emergency contact
An adult?

Parents / Legal guardians statement

I agree to participate in the cruise on the sailing ship STS "Pogoria" my daughter / my son:


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!

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.

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