Authorization for Completing Repair Program of Work

Please read the terms and conditions below, fill out the form and submit to Oak Leaf Marina. All required fields must be filled out for the authorization process to proceed.

ACCEPTANCE OF AGREEMENT

Submission of this form constitutes acceptance of the terms and conditions of this agreement or by faxing a signed copy or by personal delivery, I represent that I have read, understand and accept said AGREEMENT and the information provided to me as part of Oak Leaf Marina's on-line system. I agree with all of its terms and agree to all payments as such.

All fields of this form are required.

Customer Name:
Address:
City/Town:
State:	Zip Code:
Contact Phone:
E-Mail:
Vessel Name:
MFG/Year/Model:

Enter Verification Code: HT4K