Blue Valley Yacht Club
2001 Membership Application
Commodore: Ken Hays Ph: (785) 539-2374 Treasurer: Tom Albright Ph: (785) 776-9545
NAME___________________________________________________________________________________
FAMILY MEMBERS_________________________________________________________________________
ADDRESS _______________________________________________________________________________
________________________________________________ ZIP___________________________
HOME PHONE_____________________________ WORK PHONE____________________________
MOBILE/CELL PHONE ______________________ VHF CALL SIGN __________________________
EMAIL ADDRESS (IF YOU HAVE ONE) _______________________________________________________
BOAT MANUFACTURER_______________________________ BOAT NAME _________________________
BOAT MODEL______________________________ BOAT REG. NO. KA____________________
(Mandatory)
CO-OWNER (IF APPLICABLE)______________________________________________________________
(CO-OWNER MUST PAY MEMBERSHIP FEE)
CHECK COMMITTEE(S) FOR WHICH YOU ARE WILLING TO WORK
GROUNDS MAINT._____ HARBOR MAINT.______ RACING________
NEWSLETTER_____ SOCIAL________ OTHER_____________________________
FEES
FAMILY MEMBERSHIP $60.00 _________
MOORING 125.00 _________
(NOTE STORING A BOAT OUTSIDE THE DINGHY PARK
DINGHY PARK SPACE 80.00 _________ IS THE SAME FEE AS A DINGHY PARK SPACE)
SECOND BOAT SPACE 40.00 _________ (SECOND SPACE IS FOR MEMBERS WHO PAY FOR
A MOORING OR DINGHY SPACE AND WANT TO
SAILBOARD SPACE 15.00 _________ STORE A SECOND BOAT)
TOTAL $_________
IN APPLYING FOR MEMBERSHIP, I AGREE TO PLACE MY TRASH IN THE APPROPRIATE
RECEPTACLES, REMOVE JUNK FROM IN AND AROUND MY DINGHY PARK SPACE AND
REGULARLY MOW THE GRASS IN SAID SPACE. IF ON A MOORING I AGREE TO KEEP
MY BOAT SECURELY FASTENED TO THE MOORING FLOAT. (IF IN DOUBT CONTACT
ONE OF THE CLUB OFFICERS)
 CHECK THIS BOX IF YOU MUST HAVE YOUR NEWSLETTER SENT VIA THE POST OFFICE.
SIGNED__________________________________________________________ DATE_________________________________
PLEASE MAKE CHECKS PAYABLE TO
BLUE VALLEY YACHT CLUB
P.O. BOX 961
MANHATTAN, KS 66502
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