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Membership Application

        

Name:

Date of Birth:

Status:

Address:

City:

State:

Zip:

Home Phone:

Business Phone:

E-Mail:

Occupation or type of Business:

Name, relationship, and ages of members of immediate family.

In emergency call

Or

Proposed By:
References Or Other Club Member:

1.Name and Address:

2. Name and Address:
All Membership Subject To Applicable Taxes.

Name Of Yacht:

Type:

Length: 

Beam: 

Draft: 

 

            

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