Skeleton Crew Adventures Sailing Intake Form

URGENT ASSISTANCE

If you're facing a crisis and considering suicide, please reach out to the VETERANS CRISIS LINE by dialing 988 then press 1, or text 838255. Additional resources can be found at www.veteranscrisisline.net. In case of immediate danger, including attempted suicide or harm to yourself or others, please dial 911 immediately.

Welcome to Skeleton Crew Adventures!

Thank you for your interest in joining us for an unforgettable sailing experience. At Skeleton Crew Adventures, we are dedicated to providing veterans and first responders with sailing adventures that are not only thrilling and enjoyable but also supportive of our participants' overall well-being. To ensure we offer you the safest and most rewarding experience possible, we kindly ask for some detailed information about you. This information will help us tailor the sailing event to better suit your needs, accommodate any special requirements you may have, and ensure your safety and comfort throughout the adventure. Rest assured, all information provided will be kept confidential and used solely for the purpose of enhancing your experience with Skeleton Crew Adventures. Please take a moment to complete the following intake form as accurately and thoroughly as possible. Your cooperation is greatly appreciated and is a vital step in preparing for an amazing journey on the water.

Personal Information

Legal First Name

Legal Middle Name

Legal Last Name

Preferred Name

Email

Phone (best to reach you)

Address Line 1

Address Line 2

City

State

Please select... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Puerto Rico Virgin Island Northern Mariana Islands Guam American Samoa Palau

Postal Code

Date of Birth:

Month

Please select... January February March April May June July August September October November December

Day

Please select... 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Year

Please select... 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Legal Sex

Please select... Male Female

Relationship Status

Please select... Dating Divorced Married Single Widowed

How did you hear about Skeleton Crew Adventures?

Please select... Search Engine Family / Friend Facebook Instagram LinkedIn 'Hell or High Seas' Documentary Other

Military / First Responder Background & Professional Information

Current Military or First Responder Component (please select all that apply)

Please select... Active Duty Active Guard Active Reserve National Guard Reserves Veteran First Responder

Branch of Services

Please select... Air Force Army Coast Guard Marine Corps Navy Space Force Police Fire Medical

MOS/AFSC/SFSC/Job Title

Years of Service:

From

To

Have you ever been deployed?

Please select... Yes No

Current Employment Status

Please select... Employed Between jobs Self-Employed Retired

Sailing Experience

Swimming Ability: Please rate your swimming ability on a scale of 1 to 10, with 1 being the lowest and 10 being the highest

Please select... 1 2 3 4 5 6 7 8 9 10

Sailing Experience: Please rate your swimming ability on a scale of 1 to 10, with 1 being the lowest and 10 being the highest

Please select... 1 2 3 4 5 6 7 8 9 10

Allergies or Health Concerns: Please list any that we should be aware of

Comfort with Water Activities: How comfortable are you with activities that involve being in or around water?

Please select... Not comfortable at all Somewhat uncomfortable Neutral Comfortable Very comfortable

Physical Mobility: Do you have any mobility restrictions we should plan for on the boat?

Please select... Yes No Prefer not to say

If Yes, Please Explain:

Emergency Contact Information

Emergency Contact Name

Relationship to Emergency Contact

Please select... Spouse Sibling Parent Child Friend Other

Emergency Contact Phone Number

Documentation and Confirmation

Please upload your DD214, discharge letter, or proof of active duty

I certify that the information provided is true and accurate to the best of my knowledge

I understand that completing this form does not guarantee assistance and that Skeleton Crew Adventures is not a healthcare provider

Additional Information

Is there anything else you'd like to tell us?

Notice

*The Skeleton Crew Adventures team is diligently working through a high volume of applications for our sailing programs, aiming to deliver exceptional, personalized experiences. All intake forms are handled in the sequence they arrive. You'll receive an email to schedule your sail date as soon as we start processing your intake form.* *Skeleton Crew Adventures is committed to ensuring equality and inclusivity in all our activities, without regard to an individual's race, ethnicity, national origin, belief system, marital or family status, sex, disability, age, gender identity, or sexual orientation.*