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OSELKA MARINA

514 W. WATER ST.

NEW BUFFALO, MI 49117

 

2023 SLIP RESERVATION REQUEST FORM


For priority status, please include a $200 deposit. Deposit is refundable if a slip does not become available. If a slip is offered for rental to the person signing this form, then the deposit will be applied to the rental rate and will be non-refundable.

 

 

 

First Owner's Name

First Name*

Last Name*

Phone*
First Owner's Date of Birth*
I certify that I am 18 years of age or older
First Owner's Boat Details

Boat Name

State Registration or Documentation Number

Boat Year

Boat Make and Model

Boat Length Over All (LOA)

Boat Beam (Width)

Boat Draft (depth)
First Owner's Signature*
Second Owner's Name

First Name*

Last Name*
Second Owner's Date of Birth*
Second Owner's Boat Details

Boat Name

State Registration or Documentation Number

Boat Year

Boat Make and Model

Boat Length Over All (LOA)

Boat Beam (Width)

Boat Draft (depth)
Third Owner's Name

First Name*

Last Name*
Third Owner's Date of Birth*
Third Owner's Boat Details

Boat Name

State Registration or Documentation Number

Boat Year

Boat Make and Model

Boat Length Over All (LOA)

Boat Beam (Width)

Boat Draft (depth)
Fourth Owner's Name

First Name*

Last Name*
Fourth Owner's Date of Birth*
Fourth Owner's Boat Details

Boat Name

State Registration or Documentation Number

Boat Year

Boat Make and Model

Boat Length Over All (LOA)

Boat Beam (Width)

Boat Draft (depth)
Fifth Owner's Name

First Name*

Last Name*
Fifth Owner's Date of Birth*
Fifth Owner's Boat Details

Boat Name

State Registration or Documentation Number

Boat Year

Boat Make and Model

Boat Length Over All (LOA)

Boat Beam (Width)

Boat Draft (depth)
Sixth Owner's Name

First Name*

Last Name*
Sixth Owner's Date of Birth*
Sixth Owner's Boat Details

Boat Name

State Registration or Documentation Number

Boat Year

Boat Make and Model

Boat Length Over All (LOA)

Boat Beam (Width)

Boat Draft (depth)
Seventh Owner's Name

First Name*

Last Name*
Seventh Owner's Date of Birth*
Seventh Owner's Boat Details

Boat Name

State Registration or Documentation Number

Boat Year

Boat Make and Model

Boat Length Over All (LOA)

Boat Beam (Width)

Boat Draft (depth)
Eighth Owner's Name

First Name*

Last Name*
Eighth Owner's Date of Birth*
Eighth Owner's Boat Details

Boat Name

State Registration or Documentation Number

Boat Year

Boat Make and Model

Boat Length Over All (LOA)

Boat Beam (Width)

Boat Draft (depth)
Ninth Owner's Name

First Name*

Last Name*
Ninth Owner's Date of Birth*
Ninth Owner's Boat Details

Boat Name

State Registration or Documentation Number

Boat Year

Boat Make and Model

Boat Length Over All (LOA)

Boat Beam (Width)

Boat Draft (depth)
Tenth Owner's Name

First Name*

Last Name*
Tenth Owner's Date of Birth*
Tenth Owner's Boat Details

Boat Name

State Registration or Documentation Number

Boat Year

Boat Make and Model

Boat Length Over All (LOA)

Boat Beam (Width)

Boat Draft (depth)
Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Boat Details

Boat Name

State Registration or Documentation Number

Boat Year

Boat Make and Model

Boat Length Over All (LOA)

Boat Beam (Width)

Boat Draft (depth)
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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