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Membership Application

If you would like to apply to join Vaucluse Amateur 12 foot Sailing Club please complete this form. Existing members do not need to re-apply for membership and can go straight to the membership renewal form.

By sending this form to Vaucluse Amateur 12 foot Sailing Club (VA12SC), any of its officers, or any of its members, you:

1) Acknowledge having read the Risk Warning, Release of Liability and Conditions

2) Agree to be bound by their terms

Parents' Name

First Name

Last Name

Parents' Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Sailor's Name 1

First Name

Last Name

Date of Birth

YYYY

Sailor's Name 2

First Name

Last Name

Date of Birth

YYYY

Sailor's Name 3

First Name

Last Name

Date of Birth

YYYY

Sailor's Name 4

First Name

Last Name

Date of Birth

YYYY

Do you or your children have any medical/dietary requirements we should be aware of?

Boat Names & Sail Numbers (if you are storing a boat at the club)

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Vaucluse Amateur 12 foot Sailing Club

Apply

Membership Application