Lake City Yacht Club
New Member Application

Printable Version

Membership Applied For:
(annual dues shown in parenthesis)

Regular ($275.00)
Crew ($35.00)
Associate ($35.00)

All new Regular members pay an initiation fee of $300.00 in addition to annual dues.

Whats This?

Last Name First Name
Spouse Last Name Spouse First Name
Address City State Zip
Home Phone    
His Email Her Email
His Phone Her Phone
Winter Address (if different) City State Zip
Winter Phone    
       
Child 1 (Name YOB) Child 2 (Name YOB)
Child 3 (Name YOB) Child 4 (Name YOB)
Child 5 (Name YOB)    
       
Boat Name Slip Number
Boat Manufacturer Boat Model
Boat Length    
Mailing Lists Main



Spouse



 

Please enter the code you see in the image below into the field provided (case insensitive).
CAPTCHA Image
Reload Image

Membership is pending board approval.