Marina Boat Slip Reservation Request Form

TOWN OF SCITUATE MA
Marina Boat Slip Reservation Request Form

Please provide us with the following information. Once you have completely filled out this form, press the submit button below. You will be notified by the marina with more information regarding your request. Submitting this form does NOT guarantee a boat slip.

Note: The items beginning with an asterisk are required fields.

Title:	Captain Dr. Mr. Mrs. Ms.
* Your Name:
* Owner Name:
* Address:
* City:
* State:
* Zip Code:
Country
Home Phone:
Work Phone:
Cell Phone:
Emergency Phone:
*E-mail Address:

Name of Boat:
* Official State Registration/ Federal Documentation Number :
* Overall Length of Boat: (in feet)
* Type of Boat:
* Beam: (in feet)

* On Board Overnight:	Yes No
* Date of Arrival:
* Date of Departure:
Electricity?	Yes No
If "YES" to Electricity:	30 AMP ($10.00 PER DAY) 50 AMP ($15.00 PER DAY)
How did you hear of Scituate?
Have you stayed with us before?	Yes No
Comments: