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A 50% Deposit Is REQUIRED To Reserve
Your Spot On The Schedule!

	Captain's Orders Has My Credit Card Number On File.
	Please Have The Captain Call Me For My Credit Card Number.
	Do Not Place Your Credit Card Numer In Your Request

	* Required Item
Name:*
Email:*
Address:*
Address 2:
City:*	State:*   Zip:*
Home Phone:*
Work Phone:
Fax:
	My address and or phone has changed Yes No
Make/Model/Year/Name of Boat:*
Boat stored where?*
Boat key is where?*
Haul Date:
Boat Length:

Sign me up for:
	Shrinkwrap
	Zippered Door
	Vents      How Many?
	Sailboat Mast Up
	Powerwash Bottom
	Remove & Store Batteries
	Disconnect Batteries Only/Leave On Boat
	Winterize Engine Gasoline/Diesel	How Many?
	Winterize Generator
	Winterize Outboard
	Winterize A/C	How Many?
	Winterize Head	How Many?
	Winterize Water System
	Winterize Other (miscellaneous)
Oil Change:	Gas Diesel Generator
Storage For 30 Ft & Under
	Inside Heated Storage
	Inside Cold Storage
	Outside Storage
Haul My Boat To Captain's Orders:
	From The Marina Listed Above
	From Lakes Of The Four Seasons
	From Shorewood Forest
	From Flint Lake
	From Other

Please use the space below for any
questions or any other information you may have for the Captain.

Please add me to your mailing list:
  Yes    No  

Captain's Orders, Inc.
2058 Joliet Road
Valparaiso IN, 46385
219.531.CAPT (2278)
Fax 219.531.2998
Orders@CaptainsOrders.com


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