Memberhip App Dues Form 2015

Androscoggin Yacht Club
Wayne, Maine
New members welcome.
2015 MEMBERSHIP APPLICATION
Applicant’s Name _________________________________Phone______________Cell__________
Email ____________________________________
Spouse (if Family Membership) _________________________________________Cell__________
Email _____________________________________
Dependent Children’s names and ages: ________________________________________________
Billing Address _________________________________ City, ST _______________ Zip __________
Summer Address, same ____ or ___________________City, ST _______________Zip __________
Membership, please check one:
$55.00 ____Individual Membership entitles the individual to the following privileges and benefits of membership by
the individual only: use of the beach, docks, rowboat dock, a club rowboat, the clubhouse and grounds (subject to the
policies of the club concerning access to and use of the clubhouse and rental for private parties and functions at an
additional fee), swimming lessons and sailing lessons (at an additional fee).
$95.00 ____Family Membership entitles the individual applicant and the applicant’s spouse and dependent children to
the privileges and benefits above. Family Membership does not extend membership privileges and benefits to any other
family members. An adult must accompany children under 12 at all times.
Moorings
Mooring security and safety are the responsibility of each boat owner.
Please check if you have an existing mooring (yes) ______or (no) ______ OR
if you plan to have a new mooring dropped this summer (yes) ______or (no) ______.
To drop a new mooring, please contact the Mooring Chair, Joel Ellis (212-0109). Your cooperation in providing the
following information may facilitate location of the owner in the event of a loose boat. Your mooring must be marked
with your name and mooring number. Contact the secretary if you are unsure of your number. You will receive your
mooring number with your membership card.
Type:
Sail 9
Power 9
Pontoon 9
Kayak or canoe 9
Other 9
Name of boat _____________________________
Length_________ Color________________
State Registration # __________________ Make ______________________________________
Would you be able to lend a hand with dock launching, clean up, suppers, regatta, café night, dance, or fundraising?
Circle your preference(s).
Registration forms for Swimming or Sailing Lessons are attached or can be downloaded from the Androscoggin Yacht
Club website, www.aycwayne.org. If you have questions, contact an AYC Officer or email us at: ayc1909@gmail.com.
Mail this form with payment form to: Androscoggin Yacht Club, Edith Ellis, Secretary,
PO Box 241, Wayne, ME 04284 or visit our website to print out forms and mail in.
Please note that membership dues must be paid in full in order to rent club facilities or register for any swimming or
sailing lessons. Also, anyone using the canoe racks must tag or mark their craft with name and phone number.
An AYC member must accompany all guests.