Membership Application Complete the Application Form Below For: Full Family / Full Single /Young AdultPlease enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. - Step 1 of 3Member ApplicationComplete the Application Form Below For: Full Family / Full Single /Young AdultMembership Type *FullFull SingleYoung Adult SingleAssociateLegacyWinterName *FirstLastAdd a nicknameor if you prefer, leave blankDate of Birth (mm/dd/yyyy) *Email *Main Phone *Mobile Phone *Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeOccupation *Skills / Talents *Club Member Acquaintances *Marital Status *SingleMarriedDomestic PartnerSpouse or Domestic PartnerFirstLastDate of Birth (mm/dd/yyyy)Cell PhoneNextDo you have children under 26 years old?YesNo Child 1 NameFirstLastDate of Birth (mm/dd/yyyy) Child 2 NameFirstLastDate of Birth (mm/dd/yyyy) Child 3 NameFirstLastDate of Birth (mm/dd/yyyy) Child 4 NameFirstLastDate of Birth (mm/dd/yyyy) Child 5 NameFirstLastDate of Birth (mm/dd/yyyy) Child 6 NameFirstLastDate of Birth (mm/dd/yyyy)NextAre You Interested in a Slip or Mooring? *YesNoMaybeBoat Ownership *No BoatYes - PowerYes - SailYes - BothTell us what club activities are of interest to you and/or members of your family *BoatingSocial ActivitiesDiningSailingSail RacingJunior SailingCruisingDaysailor useKayakingVolunteeringAny Other CommentsHow did you learn about the club? *WebFriend ReferralFamilyPrint AdJunior ProgramWedding or EventOpen HouseYard SignRoad SignEditorialOtherAny Other CommentsApplicant *I agree to the terms below.I/We, the undersigned, hereby apply for Membership in the North East River Yacht Club Inc. If approved I/we agree to observe and abide by all club by-laws rules and regulations . Upon Approval, I/we agree to ratify this application by signing and returning the NERYC Membership Agreement with any initiation fees and all membership dues. Payment may be via cash, check, or credit card. By checking the button below you acknowledge the same as your electronic signature.Signature * Clear Signature Date *Spouse / PartnerI agree to the terms below.I/We, the undersigned, hereby apply for Membership in the North East River Yacht Club Inc. If approved I/we agree to observe and abide by all club by-laws rules and regulations . Upon Approval, I/we agree to ratify this application by signing and returning the NERYC Membership Agreement with any initiation fees and all membership dues. Payment may be via cash, check, or credit card. By checking the button below you acknowledge the same as your electronic signature.Signature Clear Signature PreviousSubmit Membership Restaurant & Bar Plan Your Function Marina Upcoming Event
