Sailability Graceville - Sailor Client Registration Enquiry Form
Please complete for new or return booking enquiries
Name of client
*
Title
First Name
Surname
Age
Support organisation contact
*
Name
Phone
Email
Medical conditions
Asthma
Anaphylactic
Diabetic
Epilepsy
Electric wheelchair
Wheelchair
Walking frame
Autism
Please provide any other information
Subject to availability, what vessel would you prefer for your client (all are suitable for wheelchair users)? See 'Our Fleet' for vessel photos.
*
Access 303 Dinghy - Skipper + sailor client
Walker Bay Dinghy - Skipper and 2 sailors or, Skipper + 1 sailor and 1 carer)
Pontoon boat - Sailor + carer
Subject to availability, when do you want to attend?
*
Weekly
Fortnightly
Other
What is your preferred time of arrival (please allow time to check-in and preparation for sailing)?
Emergency contact
*
Name (Parent or Guardian)
Phone
Email
Please verify that you are human
*
Submit
Should be Empty: