VYC Membership Form If you are human, leave this field blank.VYC Membership Application TermsImportant – ALL required fields (field labels followed by a * ) MUST be filled in – Photos in HEIC format are incompatible with our process so please don’t use this format – Photos greater than 1MB in size will be rejected by the form so please ensure you resize appropriately – Successful submissions are confirmed with a “THANK-YOU” message on your screen – A confirmation of receipt email should also be received shortly after submission – Please try an alternate browser if your submission doesn’t complete successfully Please contact me by clicking here if you don’t receive a screen and or email confirmation New and Renewal Membership Application Form Annual VYC Fee Structure: New Memberships – Initiation Fee (one time, nonrefundable fee): Regular = $3000, Social = $250 All Memberships – Annual Dues: Regular = $550, Social = $275 – House Account (any residue after Oct 31 is forfeit): All Memberships = $250 GST (5%) is applicable to all fees with the exception of the House Account Please see Moorage and Winter Moorage Applications for Moorage terms and fees Regular Membership applicants must reside within 100km Radius of Vernon, BC MembershipApplication Type *New (Membership Application)Renewal (Annual Membership Renewal)Change (like; Membership Type, Member, Crew, Address, Contact Info, etc.)Membership ID *Please enter # from top right of your membership cardNew Membership Type *SocialRegular (BC resident within 100km of VYC based on Home Address)Membership Type *SocialRegularAffiliate (Formally Regular)Sallboat Racing Member?YesGo Green (Paperless)1 (Receive Invoices via Email)2 (Read Tiller Topics/Newsletter Online) Skipper/PrimaryFirst Name *Last Name *Date of BirthOptionalYear of Birth *Current Photo (photo in jpg or pdf format)Please provide a current passport style Photo (submitting a Photo is optional ... submission is accepted as permission to post photo's online for things like Executive Positions) BCSC on File?Yes (on file with Office)BC Services Card (required to verify BC residency and Address)BC Services Card (photos in jpg or pdf format) *Card address MUST match Home Address (both sides of Card required) provide your BC Drivers License if combined with your BC Services Card ... you can mask BCDL#, DOB and BCPH# ... you can attach one or more files to this entryOccupation *Retired *YesSemiNoPrimary Contact # *Please provide a preferred contact #Email *Enter office@vernonyachtclub.com if you don't have an email address ... Note: this address will be used for all invoice and prime communications including confirmation of this formAlternate Contact TypeWork #Home #Cell #FAX #Text #OtherAlternate Contact DetailKey Card # *Please enter the last 8 characters printed on the VYC Security Key Card you are personally using ... if the 3 prefix characters are missing, please enter 1A: followed by the last 5 digits on the cardHow you can help *Our Club is modeled on member PARTICIPATION. Please select one or more areas you can help with.1 (Club Business: Executive Office - Publicity - Project Committees)2 (Club Services: Food - Decoration - Setup - Cleanup)3 (Club Events: Planning - Boat Show - Regatta - Invasions - Specialty Events)4 (Tech Support: Audio - Visual - IT - Website)5 (Maintenance: Building - Grounds - Marina - Equipment)6 (Marine Support Services: Diving - Clubboat Skipper - Breakwater)7 (Security Patrol Team)8 (News Letter: Tiller Topics)9 (Other)Other *PCOC on File?Yes (on file with Office)Pleasure Craft Operator CardBC Pleasure Craft Operator Card (photo in jpg or pdf format) --Add 1st Mate/Secondary (Must reside at Home Address)Spouse | Significant Other | Partner ... (Must reside at same Home Address as Primary Member) 1st Mate/SecondaryFirst Name *Last Name *Date of BirthOptionalYear of Birth *Current Photo (photo in jpg or pdf format)Please provide a current passport style Photo (submitting a Photo is optional ... submission is accepted as permission to post photo's online for things like Executive Positions)BCSC on File?Yes (on file with Office)BC Services Card (required to verify BC residency and Address)BC Services Card (photos in jpg or pdf format) *Card address MUST match Home Address (both sides of Card required) provide your BC Drivers License if combined with your BC Services Card ... you can mask BCDL#, DOB and BCPH#... you can attach one or more files to this entryOccupation *Retired *YesSemiNoContact details for 1st Mate/Secondary are Optional … entries are available in the event your contact info differs from your Skipper/Primary and or you wish to be included in all club notifications Primary Contact #Please provide a preferred contact #EmailAlternate Contact TypeWork #Home #Cell #FAX #Text #OtherAlternate Contact DetailSecond Key Card *Issue (Please issue 2nd Security Key Card $20)Decline (Decline 2nd Security Key Card)Each VYC Member (PRIMARY OR SECONDARY) is allowed ONLY ONE Security Key Card. (MAX 2 Cards/Membership) A 2nd Key Card is $20 (one time non-refundable charge) Key Card *Possess (Already have 2nd Security Key Card)Issue (Please issue 2nd Security Key Card $20)Decline (Decline 2nd Security Key Card)Each VYC Member (PRIMARY OR SECONDARY) is allowed ONLY ONE Security Key Card. (MAX 2 Cards/Membership) A 2nd Key Card is $20 (one time non-refundable charge) Key Card # *Please enter the last 8 characters printed on the VYC Security Key Card you are personally using ... if the 3 prefix characters are missing, please enter 1A: followed by the last 5 digits on the cardHow you can help *Our Club is modeled on member PARTICIPATION. Please select one or more areas you can help with.1 (Club Business: Executive Office - Publicity - Project Committees)2 (Club Services: Food - Decoration - Setup - Cleanup)3 (Club Events: Planning - Boat Show - Regatta - Invasions - Specialty Events)4 (Tech Support: Audio - Visual - IT - Website)5 (Maintenance: Building - Grounds - Marina - Equipment)6 (Marine Support Services: Diving - Clubboat Skipper - Breakwater)7 (Security Patrol Team)8 (News Letter: Tiller Topics)9 (Other)Other *PCOC on File?Yes (on file with Office)Pleasure Craft Operator CardBC Pleasure Craft Operator Card (photo in jpg or pdf format) --Add Crew/Dependant Member(s) (Must reside at Home Address) Crew is defined as dependent(s) up to the age of 19 (age exception for dependents with disabilities) NOTE: 1st Mate/Secondary is NOT a CREW Member Please fill in 1st Mate/Secondary info above Crew/DependantsCrew is defined as dependent(s) up to the age of 19 (age exception for dependents with disabilities) that must reside at the registered Home Address NOTE: All Crew Members MUST be accompanied by a Skipper or 1st Mate while on Club PropertyNameFirst Name and Last Name InitialYear of BirthNameFirst Name and Last Name InitialYear of BirthNameFirst Name and Last Name InitialYear of BirthNameFirst Name and Last Name InitialYear of BirthNameFirst Name and Last Name InitialYear of BirthNameFirst Name and Last Name InitialYear of Birth Home AddressApt/Unit NumberStreet # *Street Name *TypeAveStDrRdBlvdCloseCoveCresCrtIslandLanePlWayStreet TypeDirectionNSEWNENWSESWStreet DirectionCity *Prov *PC *Postal Code--Add Mailing AddressPlease enter your Mailing Address if it not the same as your Home Address Mailing AddressPrefixC/OGDRRPO BoxMailing DetailApt/Unit NumberStreet # *Street Name *TypeAveStDrRdBlvdCloseCoveCresCrtIslandLanePlWayStreet TypeDirectionNSEWNENWSESWStreet DirectionCity *Prov *PC *Postal Code Member ReferencesPlease provide 2 VYC Club Members as ReferencesReference 1 *Enter: VYC Membership ID - VYC Member First & Last NameReference 2 *Enter: VYC Membership ID - VYC Member First & Last Name Submit Membership FormWaiver of Rights and Subrogation ClauseIt is understood that checking agree (below) hereby waives all rights and/or subrogation rights to sue or take legal action against the Vernon Yacht Club from all liability or from any claim for loss or damage by fire and any other hazards or caused by any act or neglect on the part of the Vernon Yacht Club or its employees or members. Agree *-- I have read, understand and accept the above Waiver of Rights and Subrogation ClauseCaptcha *reCAPTCHA is required.SubmitXMLF