Passport Rewards Marina Visits

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

New, update or upgrade Annual renewal
Year of initial membership *
Name *

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

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

Yes No
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 *

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

Yes No
Type signature *
To be filled our by Loop staff
Passport level attained

Almost a Surveyor Surveyor Explorer Voyager
Name of Loop Staffer
Should be Empty: