| Name | |
| Age | |
| Gender | |
| Birthday | |
| City | |
| State/Province | |
| Zip Code |
| Home Marina/Yacht Club Affiliation: | |
| Do you consider yourself a: | |
| What type of boat do you own? | |
| If so, what size? | |
| How many hours (per week) do you enjoy time on the water? | |
| Which of these activities have you participated in during the last 12 months: | Holiday at sea, Cocktails on the coast, Bonfire on the beach |
| What type of footwear do you wear most often on your boat? | |
| What do you look for in a boat shoe? | |
| Where do you typically buy your boat shoes? |
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