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Application for Marina Berth
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Licensee/s: Name/s
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Licensee/s: Address
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Home Phone / Mobile Phone Number
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Email
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Boat Name
Boat Design
LOA
Beam
Draft
Bellerive Yacht Club Member
Applied for Membership
Yes
No
Bellerive Yacht Club Member - Number of Years
New Member
< 2 Years
3 - 5 Years
6 - 10 Years
10 Years +
Where is your boat currently berthed?
If you are planning to purchase/build a boat when will it be launched?
What will be the purpose of your boat?
Offshore Racing
Twilight Racing
Club Pennant Racing
Club cruising and on water social activities
Cruising and pleasure boating/sailing
How often do you use the clubs facilities
Never Used
Weekly
Fortnightly
Monthly
Occasionally
Any other relevant Information?
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Date
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