Burlington Sailing & Boating Club
841 LaSalle Park Road
Burlington, ON L7T 4G6

BS&BC Member Application Form

Please fill out this form to apply for Burlington Sailing & Boating Club membership.
Note that this application form is not for the Mentored Sailing Program.
Click here to apply for the Mentored Sailing Program.
If you have any questions, please send an email to membership@burlbay.com

Title

First Name*

Last Name*

Address*

Address 2

City*

Province*

Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory

Postal Code*

Email Address*

Confirm Email Address*

Phone*

Emergency Contact Name*

Emergency Contact Phone Number*

First Mate First Name

First Mate Last Name

Boat Name

Make / Model

Boat Information

Sail - Keelboat

Sail - Dinghy

Kayak

Canoe

Power

Sail #

PHRF

Registration #

Slip #

Membership Fee*

Senior Membership $535 plus 20 volunteer hours

Additional fee for 1st-year Senior Members $ 400

Additional fee Racing Fee $85 ( PHRF Cert$35+Racing Fee $50).Associate/Paddler $278

Student (18-26 yrs) $100

Junior (6-17 yrs) $35

Social $75

Would you like to donate to the Able Sail program? Please put the amount below. An income tax receipt will be issued for donations of $50 or more.

Summer compound storage - Dinghy/Monohull $95 (fill in number of boats)

Dinghy/Monohull length of boat (ft)

Summer compound storage - Multihull $105 (fill in number of boats)

Multihull length of boat (ft)

Summer compound storage - Kayak $50 (fill in number of kayaks)

Kayak length

Summer compound storage - Canoe $50 (fill in number of kayaks)

Canoe length

Winter storage is very limited. If available are you interested? *

Yes

No

How did you find out about the club? Do you know a member?*

Each Senior member is required to complete 20 volunteer hours. Hours not completed will be charged at an hourly rate of $20 in addition to the annual membership.*

I will complete my 20 volunteer hours.

I will attempt to complete my volunteer hours and pay for hours not completed.

I prefer to pay the amount of 20x$20=$400 in addition to annual membership.

Do you wish to help in a particular activity? Choose all that apply:*

Anywhere

Mentoring

Boat Maintenance

Facilities/Clubhouse

Racing/Regattas

Able Sail

Social

Officer of the Day

Cruising/Raft-ups

Please tell us what type of work you may be able to help with:*

General

Electrical

Mechanical

Plumbing

Smart Serve

Woodworking

IT

Finance

Marketing

Other

If "Other" please describe:

Liability Waiver: I agree to release and save harmless the Corporation of the City of Burlington, the Corporation of the City of Hamilton, the Regional Municipality of Halton, the Hamilton Port Authority, the Burlington Sailing and Boating Club and the LaSalle Park Marina Association, including any of their contractors, subcontractors, employees, helpers, officers or members from any and all claims whatsoever associated with the personal injury, loss, damage or destruction to personal property, however caused, during any part of the operations of Burlington Sailing & Boating Club.*

Yes

Enter the code displayed*

Note:

• Information on this form will be shown as is in the membership directory.
• All vessels stored in the compound must have liability insurance.
• HST will charged where applicable.