Guest Information Before you arrive please fill out the form below and check out our Welcome Booklet. Guest Preferences Form The form is requested to assist in identifying resources and appropriate care for guests. Please take time to fill it out completely. Thanks! Name(Required) First Last Date of Birth Month Day Year AgeAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Home PhoneMobile Phone(Required)Email I am a competent swimmer(Required) Yes No In Case of EmergencyPlease provide an Emergency ContactName First Last Relationship Home PhoneMobile PhoneEmail CommentsHealth HistoryThe following information is requested. This information will be kept confidential and shared only when as deemed needed. Any changes to this information must be provided to the boat captain. Please provide complete information, so that we can be aware of your needs. COVID-19 Vaccine(Required) Yes No AllergiesList all known and describe reaction and management of the reaction. Medical, Food, or OtherDietary RestrictionsPlease list any dietary restrictions including lactose intolerance, diabetics gluten free, or if you are a vegetarian.Medications Being TakenPlease list ALL medications taken routinely. Bring enough medication to last the entire voyage. Keep it in the original packaging/bottle that identifies the name of the medicine. NO, Medications on a routine basis. YES, Medications as follows Medications TakenList the Medication, Reason for Taking, Dosage, and Times a day taken.Do you have a history of Asthma? Yes No Do you have a history of seizures? Yes No Are you Diabetic? Yes No Do you have abnormal blood pressure or a history of heart disease? Yes No Have you ever had an anaphylactic reaction? Yes No Blood Type if known If you answered Yes, please explain.Additional Information to provideUse this space to provide any additional information about which the Boat Captain should be awareFood PreferencesPlease check those you like & add comments where necessaryFood Likes Beef Chicken Pork Turkey Lamb Fish Shellfish Veal Italian Mexican Comments about FoodBreakfast Hearty Light DessertsFood DislikesPlease be specific such as liver, broccoli, Brussels sprouts, fish, mushrooms, etc.Bar PreferencesPlease indicate brand / type of those you like & add comments where necessary. Beer Wine Gin Rum Whiskey Scotch Vodka Tequila Liqueurs Juices Soda / Mixers Soft Drinks Comments about DrinksOther Additional InformationPlease feel free to include or add anything else that will assist the crew in planning your time on Serena.NameThis field is for validation purposes and should be left unchanged.
