Small Boat Program Membership Application

* Indicates required field

Name *

First

Last

Email *

Date of birth (mm/dd/yy): *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Are you currently an Island Yacht Club member? *

Yes No

How did you hear about the Small Boat Program? *

Please state your sailing qualifications or relevant experience: *

I have read and agree to the terms of Island Yacht Club’s Small Boat Program. If you agree, and all the information above is correct, please add your initials below and submit your application.

Your initials below as signature: *

Next: Review our Waiver