Escape to Exuma Getaways! Registration Form
June 18th - 28th 2026 | $595 per person
Name
*
First Name
Last Name
Address
*
Address
Street Address Line 2
City,State,Zip
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Sales Consultant
*
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Next
BOAT DETAILS:
Boat Name:
*
Model:
*
LOA:
*
Beam:
*
Power Requirement:
*
Draft:
*
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PLEASE LIST THE NUMBER OF GUESTS
Including yourself
MarineMax Customers/Guest
Adults $595.00 each
Child (12 & under) $400.00 each
Guest Name #1
*
First Name
Last Name
Guest Name #2
First Name
Last Name
Guest Name #3
First Name
Last Name
Guest Name #4
First Name
Last Name
Guest Name #5
First Name
Last Name
Guest Name #6
First Name
Last Name
Please list any allergies
Include guest name
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T-SHIRT SIZES AND PRICING
PRICE PER PERSON | UNISEX LONG SLEVE PERFORMANCE SHIRT
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next
( X )
Adult
Ages 18+
$
595.00
Size
Quantity
S
1
2
3
4
5
6
7
8
9
10
M
1
2
3
4
5
6
7
8
9
10
L
1
2
3
4
5
6
7
8
9
10
XL
1
2
3
4
5
6
7
8
9
10
XXL
1
2
3
4
5
6
7
8
9
10
XXXL
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
Child
Ages 5 -7
$
400.00
Size
Quantity
S
1
2
3
4
5
6
7
8
9
10
M
1
2
3
4
5
6
7
8
9
10
L
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
PAYMENT INFO
A separate DocuSign will be sent to your email to complete the Credit Card Authorization Form following registration form
If paying by check please Mail to: Sandy Lafreniere | MarineMax2370 SW Palm City Rd Stuart, FL 34994
NAME ON CARD
BILLING ADDRESS
CITY, STATE
ZIP CODE
Please accept the terms and conditions
*
I authorize my credit card can be charged the above amount.
I understand cancellations for full-refund are only accepted for 30 days prior to the event.
CARDHOLDER SIGNATURE
*
Submit
Should be Empty: