Pease submit this form to reserve your space at the Safety at Sea Symposium on Saturday, Mar 28 and/or for the Practical Training on Sunday, March 29, 2009. We will acknowledge your request by email. You will be asked to pay with a check when you register at MIT.

Please indicate HOW MANY tickets next to each course below. If you are ordering more than one ticket provide the names of the other attendees.

Your Name:

Yacht Name:

SAS Tickets

Do you want to attend the Marblehead to Halifax breakout session?

Medical

CPR

Weather

In-Water

Please enter the names for multiple ticket purchases. Use a second request for more than 4 total.

Second Name:

Third Name:

Fourth Name:

Comments: