Passport Rewards Marina Visits

Passport Rewards Marina Visits
Is this a renewal or a new visit allocation*

New, update or upgradeAnnual renewal
Year of initial membership*
Name*

First NameLast Name
Vessel Name*
Email*
example@example.com
Phone Number*

Area CodePhone Number
Are you a long term Slipholder at an Albemarle Loop Marina

YesNo
What LOOP Marina do you have long term dockage at
If you are renewing, please enter the member level and the marina (s) you are visiting this year.
If you are a slip holder a an Albemarle Loop Member Marina, Only 2 days will be credited to you for that marina.
Renewal Member Level*

SurveyorExplorerVoyager
You will be notified by email on how and where you can redeem your rewards.
Loop marina visits*
I certify that these entries are correct*

YesNo
Type signature*
Please verify that you are human*
To be filled our by Loop staff
Passport level attained

Almost a SurveyorSurveyorExplorerVoyager
Name of Loop Staffer
Should be Empty: