Pearl Harbor Yacht Club 57 Arizona Memorial Drive, Slip 127 Honolulu HI 96818
Membership Application Membership Type: ___Full ‐ $100 Absentee ‐ $50 Youth ‐ $30_ # Additional Fam Members: ($30/each) ___________ Initiation Fee: $20_ Total Amount: $_______________ Note: dues are pro‐rated for new members: (75% for Apr‐Jun, 50% Jul‐Sep, 25% Oct‐Dec) Primary Member: Birthdate: Email: Phone: Spouse: Birthdate: Email: Phone: Kids (17 or younger): Address: Zip: City: State: l
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Length: Type: Publicity Chandlery Membership Training Other I certify these statements are truthful and I agree to act in accordance with the constitution and by‐laws of the Pearl Harbor Yacht Club. I understand that I am responsible for guests and visitors brought to Club functions and events. I will notify the Club of any change in my name, address, or eligibility status that may affect my membership. Furthermore, I agree to hold harmless and indemnify the United States, Department of Defense, Department of the Navy, and any of its agents or sub‐units for claims from any of the organization's activities Date: Primary Member's Signature: Spouse’s Signature: Date: I certify from personal knowledge that the applicant is of good character and is congruent with goals and objectives of the Club. I agree to introduce the applicant to the Club and accompany the applicant during the initiation process. Print: Member #: Sign: OFFICE USE ONLY: Submission Date: Membership Chairperson: Member #: __________ Processed by: Decision: www.pearlharboryachtclub.org Date: