CREW PROFILE FORM
Thank you for joining our team! As you will soon be boarding the Sea Dragon we need some information from you for a smooth voyage.
* Required
CONTACT DETAILS
*
Your answer
Address Line 1
Your answer
Address Line 2
Your answer
City
Your answer
State/County
Your answer
Trip
*
Select your voyage
Choose
May 2019: Border Run | San Diego to Ensenada
May 2019: Pineapple Express | Ensenada to Hawaii
June 2019: Pacific Explorer | Hawaii to Kiritimati
July 2019: Pacific Voyager | Kiritimati to Hawaii
July 2019: North Pacific Gyre | Hawaii to Victoria
August 2019: Gulf Islands | Victoria to Seattle
August 2019: San Juans | Seattle to Vancouver
Zip/Post Code
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Country
Your answer
Email
Your answer
Phone Number
No formatting please! For example: 19204121234
Your answer
How did you find out about Pangaea Exploration / this expedition?
Please be as specific as possible
Your answer
Passport Details
Full Name as written on passport (first, middle, given/last name/surname)
Your answer
Passport Number
Your answer
Nationality
Your answer
Date of Birth
Format: dd-Mmm-yyyy For Example: 22-Jan-1985
Your answer
Date of Issue
Format: dd-Mmm-yyyy For Example: 22-Jan-1985
Your answer
Date of Expiry
Format: dd-Mmm-yyyy For Example: 22-Jan-1985
Your answer
Sex
Female
Male
Emergency Contact/Next of Kin
Name
Your answer
Emergency Contact Relationship
Your answer
Emergency Contact Home Phone Number
No formatting please! For example: 19204121234
Your answer
Emergency Contact Mobile Phone Number
No formatting please! For example: 19204121234
Your answer
Emergency Contact Email Address
Your answer
Arrival Date, Time, and Flight Number
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Departure Date, Time, and Flight Number
Your answer
Please check if you require visas for departure and/or arrival ports
No, I don't need one
(if yes) Approved visa number
Your answer
Practical Information
Dietary requirements and food allergies
Your answer
Maritime training/experience (if any)
Your answer
Medical Conditions
Please remember offshore sailing can be a strenuous activity and you will be a long way (many days) from medical help. There is a separate comprehensive medical history form to fill out but please use this box to tell us if there is an ongoing health concern we should discuss beforehand. Thanks.
Your answer
Can you swim?
*
Yes
PROFILE
This information will be provided to the crew
Background and area of expertise
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Goals and aims for the expedition
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