Membership Application Form | Sailing and boating on Burlington Bay

Title

First Name*

Last Name*

Address*

Address 2

City*

State/Province*

Zip/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

Sail / Power

Sail

Power

Sail #

PHRF

Registration #

Slip #

Base Membership Fee*

Other Fees

First year Senior $400

Racing Fee $85 (PHRF Cert $35 + Racing Fee $50)

Summer Compound Storage

Monohull $95

Multihull $105

Kayak/Canoe $50

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

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

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

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

Is it important to you that you get all of your volunteer hours?*

yes

no

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

Please tell us what skills you have or the type of work you may like to help with:*

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

BS&BC New Member Application Form