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THE PENINSULA YACHT CLUB

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                   THE PENINSULA YACHT CLUB




        APPLICATION FOR MEMBERSHIP PRIVILEGES

_____________________________________________________________________________________________
__________________________________________________________________________________________




_____________________________________________________________________________________________
__________________________________________________________________________________________

                   THE PENINSULA YACHT CLUB
                  APPLICATION FOR MEMBERSHIP PRIVILEGES
The undersigned hereby requests consideration for a membership at The Peninsula Yacht Club. If approved,
the undersigned requests that his/her name be placed on the Membership Roster as follows.

                                     MEMBER INFORMATION

Mr.     Mrs. Ms.        Miss    Dr.
Name of Applicant/Primary Member (Please Print)____________________________________________
Local Address ________________________________________________________________________
                 Street
                ________________________________________________________________________
                City                                 State                          Zip
Dates Most Often at This Address (From ______________ to ________________)
Telephone # (______)______________________
Out-of-Town Address __________________________________________________________________
                        Street
                ________________________________________________________________________
                City                                 State                          Zip
Dates Most Often at This Address (From ______________ to ________________)
Telephone # (______)______________________
Social Security #__________________________          Date of Birth____________________________
Driver's License #_________________________          State __________________________________
Marital Status (Optional): Single      Married       Wedding Date __________________________
Name of Employer _____________________________________________________________________
Occupation and/or Nature of Business______________________________________________________
Title____________________________________            Years in Present Employment ______________
Business Address ______________________________________________________________________
                  Street
                 _______________________________________________________________________
                 City                                  State                        Zip
Business Telephone # (______)__________________       Fax # (______)_________________________
E-Mail Address (Personal) _____________________       E-Mail Address (Business) _______________
Does the member desire to be named in the Member Directory?            Yes            No
Please Mail Club Billings To:       Local               Out-of-Town              Business
Please Mail All Other Club
        Correspondence To:          Local               Out-of-Town              Business

                                      SPOUSE INFORMATION
Mr.      Mrs.    Ms.    Dr.
Name _______________________________________________________________________________
Social Security #________________________________ Date of Birth___________________________
Driver's License #___________________________        State__________________________________
Name of Employer_____________________________________________________________________
Occupation and/or Nature of Business______________________________________________________
Title ______________________________________         Years in Present Employment______________
Business Address______________________________________________________________________
                   Street
                   ____________________________________________________________________
                   City                              State                          Zip
Business Telephone # (______)_________________       Fax # (______)_________________________
E-Mail Address (Personal) ____________________       E-Mail Address (Business) ________________
                                                - 1-


_____________________________________________________________________________________________
__________________________________________________________________________________________

COMPANY/MEMBER INFORMATION (If requesting an entity-owned membership)

Full Name of Company____________________________________________EIN#_________________

Mailing Address_______________________________________________________________________
               Street
               _______________________________________________________________________
               City                            State                      Zip

Type and/or Nature of Business___________________________________________________________

                                    REFERENCES

OTHER CLUB/SOCIAL REFERENCES (Both Member and Spouse)

1.     ______________________________________________________________________________
       Name of Club/Organization                     Member For What Dates
       ______________________________________________________________________________
       City                      State               Present/Former Member

       Are you in good standing?     Yes    No
       If no, please explain______________________________________________________________

2.     ______________________________________________________________________________
       Name of Club/Organization                     Member For What Dates
       ______________________________________________________________________________
       City                      State               Present/Former Member

       Are you in good standing?    Yes    No
       If no, please explain______________________________________________________________

PERSONAL REFERENCES (Not Members Of The Peninsula Yacht Club)

1.     _________________________(_____)_______________________________________________
       Name                      Telephone #                Years Known
       ______________________________________________________________________________
       Street
       ______________________________________________________________________________
       City                                   State                        Zip
2.     __________________________(_____)______________________________________________
       Name                       Telephone #               Years Known
       ______________________________________________________________________________
       Street
       ______________________________________________________________________________
       City                                   State                        Zip

SPONSORING MEMBER/SPONSORING CLUB REPRESENTATIVE

        __________________________________ (_____) _____________________________________
        Name                                  Telephone #                Years Known
Has either the Applicant (primary member) or Spouse ever been convicted of a felony or other crime
involving        moral         turpitude?      ______________          If        so,         please
explain:_________________________________________________________________________________
                                              - 2 -

_____________________________________________________________________________________________
__________________________________________________________________________________________


         1.       Classification Of Membership Privileges. The undersigned hereby requests consideration
for the classification of membership at The Peninsula Yacht Club indicated by marking the appropriate box
below and agrees to pay the non-refundable membership fee set forth below.

                                                            Non-Refundable
          Classification of Membership                      Membership Fee

                Social Membership (individual)                   $ 3,000.00
                Social Membership (entity-owned)                 $ 5,000.00
                Yacht Membership                                 $_________
                                                                           (membership fee will vary
                                                                          based on length, width and
                                                                          location of slip---see
                                                                          accompanying schedule
                                                                          for the current pricing sheet)

        • If the Yacht Membership is to be entity-owned, then the applicant must pay an additional
        non-refundable membership fee equal to $ 2,500.00.

        If the undersigned is making application for a Yacht Membership then the applicant must also
        submit a completed Vessel Information Statement to The Peninsula Yacht Club.

         2.      Immediate Family Members. If making application for a membership to be owned by an
individual, please specify below the names of each unmarried child of the primary member and spouse who
are under the age of twenty-three and either living in the primary member’s household or attending school on
a full-time basis that will have use privileges at the Club Facilities.

        Name (First & Last)                     Date of Birth            Male          Female

1. ________________________________ ___________________ __________ ____________

2. ________________________________ ___________________ __________ ____________

3. ________________________________ ___________________ __________ ____________

4. ________________________________ ___________________ __________ ____________

        3.      Membership Approval Process.             The undersigned understands that membership at
The Peninsula Yacht Club is subject to approval. In the event this Application for Membership Privileges is
acted upon favorably by the Club, the Club will so notify the undersigned and invite the applicant to
membership. If this Application for Membership Privileges is not acted upon favorably, the Club shall notify
the undersigned that he/she will not be invited to membership.

        4.       Qualifications For Membership.          By signing this Application for Membership
Privileges, the undersigned represents that the above information is true and correct and hereby authorizes
The Peninsula Yacht Club and its representatives to conduct such inquiry into the undersigned’s
qualifications for membership as they deem appropriate, including contacting credit reporting agencies and
requesting a consumer credit report and authorizes the disclosure and release of information to The Peninsula
Yacht Club and its representatives for investigating the undersigned's qualifications for membership and
further authorizes those persons or entities identified herein to furnish such information to The Peninsula
Yacht Club and its representatives as may be requested for such purpose.

                                                    -3-

_____________________________________________________________________________________________
__________________________________________________________________________________________


Note: The Club will not act on an application request, until the undersigned Applicant submits this
      Application for Membership Privileges, an executed Membership Agreement and the
      required membership fee to The Peninsula Yacht Club at the address set forth below.


If requesting consideration for an individual membership:


Date: _____________________                   Signed:____________________________________
                                                     Applicant/Primary Member

Date: _____________________                   Signed:____________________________________
                                                     Applicant’s Spouse



If requesting consideration for an entity-owned membership:

______________________________       _______________________________       ____________________
Print Name of Company Applicant       Print Name of Officer                Title of Officer

________________________      ______________________________________
Date                          Signature of Officer




                                     The Peninsula Yacht Club
                                   18501 Harbor Light Boulevard
                                  Cornelius, North Carolina 28031
                                           704-892-9858
                                     www.peninsulayacht.com
                                                                                       February 2005
                                                -4–

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