NAME:                  

                                 Last                                                                                       First                                                       MI

ADDRESS:

                                   Street
                                                                  City                                                  ST
         Zip

Phone:

                                  Home                                                     Business
                                            Cell

E-Mail
Address: 1.                                                                             

2.

Spouse:

Children:
1.

2.                                                                              3.
                                                           4.

BUSINESS
ADDRESS:

INTERESTS:

BOAT
INFO:

                                                                            Name                                   Make                           Length              Draft

SPONSOR
NAME:

I AGREE TO ABIDE BY THE RULES AND REGULATIONS OF
CMC/MBYC.

I understand keys remain property of MBYC and must be
returned for a refund of deposit upon resignation of membership. Keys may not be used by unauthorized
personnel

                         Applicants
Signature                                                                Date

For
Administrative Use Only: Please copy Secretary, Treasurer and Data Base
Manager

INITIATION
FEE $50

PAID

DATE:

2023
ANNUAL DUES $800

PAID

DATE:

APPROVED
BY THE BOARD OF DIRECTORS:

                                                                                                                                 Date                         Secretary
Initials

Key
Deposit: $50. Ea.

Paid:

Key
#(s)

                                                                                                   Date 

Secretary
Initials