Skipper: _______________________________________________________

First Mate: _____________________________________________________

Address: _______________________________________________________

City: _____________________________________ ST ____ ZIP _________

Telephone: (H)  ______________(W) ______________(B) ______________

E-mail _____________________________PHRF Rating (if known) ______

Boat Name ____________________ Class/Mfg________________________

Model _______________ Length ___________ Sail No _________________

Radio: _____ Yes _____ No

(Optional)  Location: McKinley: __________ South Shore: _____________
Slip No. ________       Mooring: ____________
Dry Sail: ____________  Trailer: __________  Other: __________________

Yes I would like to join MAST ($20 /year) _____
Yes I want to join and race ($50/year) ______
 

AGREEMENT
In consideration of MAST Yacht Club granting me membership and/or racing privileges I hereby agree to hold MAST, its directors, officers, committeemen, and agents harmless from any and all claims arising from personal injury to myself, or damage to property, in anyway resulting from MAST activities.  I further agree to act in accordance with the Bylaws of MAST and any rules or regulations duly promulgated with respect to any MAST activity, and understand that failure to abide by same may result in suspension of my membership and or racing privileges.

Signature  _____________________________________________

Date  ________________________________

Mail to: Fergie Locke -  1908 E Cumberland Blvd., Whitefish Bay, Wi  53211