Course Booking Form

Please complete and submit the booking form below.

A separate booking form must be submitted by each candidate.

In order to secure your booking, please submit this booking form and send proof of deposit/payment to mailto:info@atlanticyachting.co.za. Please use your surname as reference when making a payment.

Details of person responsible for account- (* required field)

Full Names and Surname *
(as it must appear on the invoice)

E-mail address *

Contact number *

VAT number (if applicable)

Postal Address

Postal Code

Physical Address

Postal Code

Course for which booking is made *

Start Date

End Date

Details of student

Full Names and Surname *

Identity/Passport Number *

Date of Birth *

Mobile Number *

E-mail Address *

Sex *  Male Female

Sailing Experience / Miles

Shorebased Contact/Next of Kin
(In case of emergency) *

- Name and Surname

- Relationship

- E-mail Address

- Postal Address

- Postal Code

- Contact Number

Security Code : captcha


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