Membership Application

Print and mail to:

Collingwood Yacht Club Incorporated

P.O. Box 56, Collingwood ON L9Y 3Z4

www.collingwoodyachtclub.com

Personal Information

First Name:………………..Last Name:…………………………….Partner’s Name:………….…………….........

Address:

Street:…………………………………………….…Home Phone:….…………………Email address ...….........

City:………………………………Province……….Postal Code:…………….Other Phone:…….……...............

Boat Information

Boat Name:……………………………………………………………Manufacturer:.……………………………………

Model: …………………………………………………………………Power/Sail:……………………………………..…

L.O.A.:……………....Beam:……………….Draft:…………….…...Displacement:………………Colour:…..………

Other:

Insurance Company:………………………………………….……..Policy Number:….………………….…………….

Liability Amount:……………………………………………………..Expiry Date (M/D/Y):……………..………………..

Will you fill our 10 hours work requirement each year? Y/N (If no, you will be billed for hours not worked)

Do you have any special talents, trade skills or abilities to offer in lieu of work hours? (If yes please describe)

I hereby release Collingwood Yacht Club Incorporated from any liability or responsibility in any way for damages however caused, to my boat(s) and/or property whilst in or on Collingwood Yacht Club Incorporated premises. I also acknowledge that I must maintain at least two million dollars ($2,000,000.) liability insurance on my boat at all times.

Date:………………………………………… Signature:………….………………………………………………….

Witness signature:……………………………………Witness name (please print):…………..……..……..…..

Witness address: ……………………………………………………………………………………………………

Sponsor’s Name 1:…..……………………………..…… Sponsor’s Name 2...……………………………...…

For club use only

Amount Paid:…………….. Date Accepted (M/D/Y) :…………………………

MemberType: Full/Associate/Social