MARINA REQUEST FORM
BERNARD'S LANDING RESORT & CONFERENCE CENTER

Click here to review marina policies and current fees in the Marina Handbook
xx

Date of Request

Name

Sub Association (example: Peninsula)

Unit Number

Phone Number where you can be reached in case we have questions

E-Mail Address:

Type of Lease Requested (Check One)xxxxxx

Covered Slip (Waiting list deposit of $100 is required. You name will not be placed on the waiting list unfil the day your check is received. Make check payable to Bernar'ds Landing CPOA and mail to: BERNARDS LANDING CPOA, 900 Ashmeade Road, Moneta, VA 24121)

Uncovered Slipxxxxx PWC Space xxx Boat Compound Spacexxx Offsite Decal

Boat Information

Hull Type xxxxxBoat Length

Boat Registration # xxxxxTrailer Tag #


Notes/Comments