New Member Application and Annual Membership Renewal Form
Please make a copy, fill it out, and mail it to the above address.
Date: _____________________________
Please check either new member or renewal.
New Member: ______________________ Renewal: ____________________________
Name: _________________________________________ Member # _______________
Address: ________________________________________________________________
City:
Phone: ___________________________ Cell Phone: ____________________________
Date of Birth: ____________________________________________________________
Email address: ___________________________________________________________
Boater ___________________________ Non-Boater_____________________________
Bow Number for Boaters ___________________________________________________
Annual Dues = $25.00 ($10.00 of your annual dues goes towards the cost
of the Club Liability Insurance).
Amount Paid: ______________________
Cash_____________ Check____________ Other _______________
Received By: ____________________________________________