Emergency Information Form

All members of the La Paz community are welcome to store their medical and emergency contact information with Club Cruceros. The information will be retained by the Club and used when you are in need.

Fill in the online form below and please include as much information as you have available. The more details we provide to emergency personnel the better they can assist you should you be incapacitated. All information will be stored confidentially and only accessed in case of an emergency.

This information may save your life!


Scroll down... you're not done until you get to the submit button!

Hint: Country Code for USA and Canada is +1, Mexico is +52, click here for others.