Illiana Yacht Club Membership Application

Please print the application below and fill in the information.  Mail the completed application enclosing a check or money order to:

Attn:  Membership - Illiana Yacht Club, Inc. PO Box 662, Whiting, IN 46394

 You will receive an email indicating that we have received your application within a week and what your likely status will be.  Once your membership is accepted, you will receive additional documentation and a membership card in the mail along with several other pieces of information.  Questions?  Email us!

 MEMBERSHIP Record Form                          Referred by IYC member _____________________ or   Website Application

Name: ______________________________________                         Spouse’s Name: ____________________________

Applicant’s Birth Date:_________________________                         Spouse's Birth Date:_________________________  

Address: ________________________________________________________________________________________

Phone-Home  (____)  ____________________ Work (____)  ____________________________

Email Address: ________________________________________________________________

Children under age 21 - Name, Month , Day & Year of Birth: _______________________________________________________________________________________________

_______________________________________________________________________________________________

Employer (Optional)_________________________________ Address _______________________________________

Job Title or Duties ________________________________________________________________________________

Special Skills / Hobbies /Interests_____________________________________________________________________

Type of Boat(s) Owned & Size  (if any)_________________________________________________________________

In consideration of my acceptance as a member(s) of the Illiana Yacht Club I/we agree to abide the rules and by-laws of the club.  I/we understand that membership entails a commitment of service time and effort on my/our part in the support of Club maintenance, facilities and functions, each member contributes his/her fair share.  I/we further agree that sixty (60) days after my membership terminates, for any reason, the Board of Governors is authorized to dispose of any of my/our  property remaining on the Club premises as they see fit and for the benefit of the Club with no responsibility to account to me/us. I/we also agree to assume all liability for any guests I/we may bring to the IYC grounds and to hold harmless IYC, Inc. from any damages that may arise from said guests activities and I/we assume all responsibility for any damage or harm said guest(s) may incur while on the club premises.  Upon acceptance as a member you will be required to sign a liability waiver.

Date ___________________                                                                 Signed ____________________________________

Additional Signature if required (Spouse - Parent/Guardian               Signed ____________________________________

            NOTE: Parent/Guardian signature required if applicant is under 18 year

Date received by committee____________________                      Membership Chairman    _________________________

Date new member furnished :  Copy of By-Laws and Rules: ______________ Membership Card    ______________________________________________________________________________________________________________________