MEMBERSHIP RENEWAL FORM 0910 by wanghonghx


									                                                     Canberra Yacht Club
 PO Box 7169 Yarralumla 2600                           Tel (02) 6273 7177     Fax (02) 6273 6222
  Mariner Pl, Yarralumla ACT                            email:
     (ACT Sailing Inc T/A) ABN 93 090 967 514            Website:

                               MEMBERSHIP 2009/2010 APPLICATION / RENEWAL
                                   (1 Oct 2009 - 30 Sept. 2010)
     Please read carefully, tick the appropriate box(es), insert amounts to be
      paid/discounted, and complete the personal details on the reverse side. Payment may
      be made by cash, cheque, money order or credit card.
     Note that application for boat parking and race entry require separate forms.
     To be considered for a boat park at the CYC, either internal rack storage or outside in
      the boat parking area, you must be a financial member of the CYC.
     When completed please send to the above mailing address or hand to the Office
      Manager at the Club.
     I do not wish to have my photo used for CYC promotional use, or my email address made available to
      class representatives or CYC members.

The following fees include the relevant Yachting Australia/YACT fee which is compulsory for all yacht club
members. A discount for Canberra Southern Cross Club (CSCC) members is available on presentation of
a current CSCC membership card. The discount is not applicable to Juniors.

Tick membership category sought:                         (Age as at 1 October 2009)                              Enter $
  Adult                 :     $190
 Family                 :     $315                      (incl. spouse and up to 2 children under 18 years)
 Student                :     $120                      (full time, 18-23 years)
 Junior                 :     $ 40                      (under 18 years)                                      $………….
CSCC Member Discount     :    - $ 10                     (for all but Junior memberships)
CSCC Member?                  If Yes, Insert Member Number ………………………..                                        - $...............
                                                CSCC exp. date………………………..
Non-CSCC Member?
If you wish to become a CSCC member please complete a CSCC Membership Application Form which is
available at the CYC Office and pay your fee at the nearest CSCC or you can apply and pay on line at

    Trailable Yachts & FF15’s                                    $ 80 FSE;       $15 single race
    Dinghy and OTB catamarans (discounted)                       $ 70 FSE;       $10 single race
    Student (full time, 18-28 yrs)                               $ 50 FSE;       $ 5 single race
    Junior (under 18 years)                                      Free for all club races
    Midweek Twilight Series only, adults                         $ 60 Series;    $ 5 single race
    Winter Series only, adults                                   $ 60 Series;    $10 single race
The FSE (Full Season Entry) includes entry to the CYC Club Championship, Pointscore and Twilight Series
races during Summer, plus all of the Winter Series races.
NOTE: FSE attaches to the boat, not the skipper.
Regatta and other series fees are additional and will be advised separately.
                                                              FSE amount if applicable $................
Club History: I wish to purchase the Club History book(s) (Tick if to be picked up  or mail delivery )
 From Lake George to Lake Burley Griffin            $25
 Capital Sailing - 1959 to 2009                     $30
 Both of the books                                  $50
 Postage                                             $10               Total Amount $................
Member’s Details
Surname :

First name :

Date of birth (if Junior/Student) :

Do or did you have a YA membership number                 Yes / No     :

If so, with which sailing club :                                  YA number (if known) :

Spouse/Partner (if applying for family membership)
Surname :

First name :

Do or did you have a YA membership number                  Yes / No        Number (if known) :

Children (if applying for family or junior membership)
1. Surname :

First name :

Date of birth :

Do or did you have a YA membership number                  Yes / No              No. (if known) :

2. Surname :

First name :

Date of birth :

Do or did you have a YA membership number                  Yes / No              No. (if known) :

For additional children, please attach a separate application form

Contact telephone numbers
Home                          Work                            Mobile                        Spouse/partner contact details

Residential Address:

Postal Address (if different from above):

Email Address :                                           @

Office Use Only
Receipt/date      Membership type     Boat storage type        FSE                 Amount(s) rec’d   Date entered MY CLUB

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