Members  Name
Last First Spouse

Check Box if same as last year (no changes, Except those noted below) 

Check Box only if you do not want your information posted on the CLYC web site.

Children (At home under the age of 21)

Mailing Information for Summer (May thru August)

Address City StateZip
Phone      Email 1 
 (Free additional Email address     Email 2 
   for the Crows Nest)                      Email 3 
 

Mailing Information for Winter (Sept thru April) (Only complete if different from Summer)

Address City StateZip
Phone       Email

Lake Address for Year Book (Only complete if different from above)
Address
Phone     

Crows Nest  (weekly newsletter)
I prefer to receive the newsletter by Email    US Mail (may check both email and US MAIL)
Please consider and select Email only to assist us in communicating quickly with you, while keeping our costs low.  

Membership (check all that apply)
     Required for Racing and Non-Racing Members
Family membership                                $ 100.00    (Includes all unmarried dependents under 25 years of age)
                                                                                           (You must have a family membership to register racing boat)

      Racing Members (A,E,C,MC,and Hobie)
Racing Boat 1                                            $ 140.00     
Racing Boat 2                                            $ 140.00     
Racing Boat 3                                            $ 140.00     

    Racing Members (X Boat only)
Racing X Boat 1                                        $50.00       
Racing X Boat 2                                        $50.00       

Optional  ===================================================================================
 Donation to CLYC Sailing School                         (Enter the $ in the box, this is tax deductible)                                      $   

CLYC Email Address                             $   10.00      Enter your name below in the box that you want for the email address
                                                                                               (Name@clyciowa.com) @clyciowa.com
===========================================================================================
   
 Membership Total                       (Renewals after May 15, are subject to a late fee of $10)                                               $  

==============================================================================
Boat Registration
Class     Select X MC MC Sat C E A Cougar Hobie Sail Number Boat Name   
Skipper                           Age X or MC     Years old

Class     Select X MC MC Sat C E A Cougar Hobie Sail Number Boat Name   
Skipper                           Age X or MC      Years old

Class     Select X MC MC Sat C E A Cougar Hobie Sail Number Boat Name   
Skipper                           Age X or MC      Years old

Racing Information (optional)
Please list the regattas your attended last year and your results.
Regatta Location Final Standings
Regatta Location Final Standings
Regatta Location Final Standings
Regatta Location Final Standings

New Membership(optional)
PLEASE LIST POTENTIAL NEW MEMBERS WITH ADDRESSES. A REGISTRATION FORM WILL BE MAILED:
Name AddressCity State Zip
Name AddressCity State Zip

Payment 
Please check the appropriate credit card
Master Card            Visa 
Name as it appears on the card  
Credit Card Number 
V Code   The "V Code" is a 3 or 4 digit number that appears in the signature section of the credit card. 
Exp Date