Request A Captain Payment Form

Request A Captain Payment Form

Please provide the information for your outing. Note: You must already have a captain who has agreed to the excursion. You must also have the boat reserved for the excursion for which you are responsible for fuel use.
Name*

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

Area CodePhone Number
Number of Passenger Who Will Be On Board (Max. 6)
If you have more than six passengers, you will either have to request another boat and captain or leave some passengers at the dock.
Captain Requested*
If you don't see the captain you've spoken with, please let them know to contact Max Curtis so they can be added to this list.
YESNO
Cruise Date/Time*
1. Until a captain confirms a my date, time, and location via my contact number, the outing is still in the scheduling phase.2. I have contacted and finalized a date/time/location with the captain from this list: https://sites.google.com/view/fbctb-captains/home3. I have reserved the vessel and understand that I am responsible for the fuel use.4. I understand the current Freedom Boat Club Rules and Regulations as they pertain to my membership and this particular excursion. https://sites.google.com/fbctb.com/rules-and-regs/home5. I understand that the max. capacity for this cruise is six passengers6. I understand that I must cancel with at least 24-hours notice or I will have to pay $150 of my cruise payment refund per captain.7. I understand that the maximum distance for "off-shore" fishing is 9 (nine) nautical miles.

Today's Total

Requested Captain - Fishing$75.00

This service is $75/hour. Please choose the number of hours you would like to be out with the captain.

Quantity

Requested Captain - Cruising$60.00

This service is $60/hour. Please choose the number of hours you would like to be out with the captain.

Quantity

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Payment Total
Should be Empty: