* are required fields

*From: (Organization):

*Point of Contact Person:

Title:

*Address:

Address 2:

*City:

*State:

*Zip Code:

*Primary PH:

Secondary PH:

Fax:

*Email:


DAMAGE

*Damaged Shell is:

*Name of Boat:


8+ 4+ 4 2x 1x

*Manufacturer:

Year of Manufacture:

Serial Number (if known):

*Damage Sustained:

During transportation
During storage
Use on the water
Other :

Date of Damage (approximate):

*Damage to:
(check all that apply)

 Bow Stern Keel Port
Starboard Coxseat
Other

*Insured?

 Yes No

*Insurance Company:


PICKUP AND DELIVERY

Standard production time is four to six weeks from receipt of shell. Expedited orders may incur additional charges.
*DATE NEEDED BY:
Regatta Needed for:
I will deliver the shell to The Rowing Repair Center

I will pick up the shell from The Rowing Repair Center


OPTIONS

I am interested in discussing the following options for my repair:

I need to arrange pick up and/or delivery by the Rowing Repair Center
I want to change the paint colors on the interior and/or exterior
I am interested in adding custom decals (stripes, logos, etc -2 shell names included)
I would like to replace missing and broken hardware

SUBMIT AT LEAST THREE COLOR PHOTOS OF DAMAGED SHELL after completeing and sending this form to: tims@rowingrepair.com
Please make sure the subject line of the email includes the date and your organization's name.