Please follow the numbered stages and complete all fields required.1 Customer DetailsIf you are a prospective purchaser booking a survey lift, please enter your own details here and not those of the current owner.Name* First Last Address* Street Address City County / State / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Home Telephone*Mobile Telephone*Email* Are you an Annual contract holder?* Yes No Vessel Name*Vessel Current Location*Class of Boat*Type of Boat*Keel Type*L.O.A. (incl. bowsprit)*Beam*Draft*2 Lift DateSelect a date* Date Format: DD slash MM slash YYYY 3 Lifting LocationsAre the lifting locations clearly marked?* Yes No PLEASE NOTE: In the absence of any lifting marks we will use our best judgement. No liability can be accepted for any consequential damage.Please indicate which drive you have: Outdrive No under hull drive Sail drive Shaft drive 4 Lift ActivityTick all that apply Haul out to: MYH cradle Owner's cradle Shore up Owner's leg Trailer Relaunch Haul out Lift to road transport Hauliers name Launch Lift from road transport ETA Racing scrub (includes pressure wash) Survey slip (includes pressure wash) Surveyors name Special offer (see seasonal adverts) Offer details Pressure wash bottom and scrub the waterline 5 Additional Yard InstructionsIf additional space is required please email or attach a separate sheetUntitled6 Masts and RiggingTick all that apply There is no mast Leave mast in situ (For haul our vessel must have cradle/legs/bilge keels) Unstep mast and lash for transport Unstep mast, check and store / Step mast, tune and pin Remove Refit / Boom Spinnaker pole Unbend sails and store below / Bend sails back on MYH Electricians / Owner to connect / disconnect mast electrics These services are provided by Mylor Rigging and will be invoiced direct by them. For additional rigging services please contact them direct on Tel: 01326 375482, Email: firstname.lastname@example.org Essential Actions Please ensure that boat keys are with MYH office prior to lift Please ensure that boat name is clearly visible on hull or cradle / trailer Please check you have valid insurance cover afloat / ashore 8 ConfirmationI hereby instruct Mylor Yacht Harbour limited and/or its contractors to carry out work detailed above and have read and agree to the terms and conditions of business. i understand and accept that, for the purposes of processing my request, my details will be kept on a database at Mylor Yacht Harbour and will be passed to the necessary contractors for their records.Signature of individual completing form:*Date* Date Format: DD slash MM slash YYYY Safety NotesNo use of MYH ladders. All customers must supply their own ladders. For further safety information and guidelines please refer to the document 'Useful Information & Guidelines' available separately.EmailThis field is for validation purposes and should be left unchanged.