INDIANAPOLIS SAILING CLUB
2012 MEMBERSHIP APPLICATION
Return this application to:Date of application: ______
Karen Chagnon
Membership Chair Note: see below for possible discount if joining
5717 Durham Castle Ct #318June 1st or later. Payment toward both the
Indianapolis, IN 46250 initiation fee and annual dues if necessary
(317) 513-5126 must accompany this application. Year-round
boat parking is extra and needs to be paid in full. Make check payable to ISC.
TO: Board Of Directors
Indianapolis Sailing Club, Inc.Amount paid:______
______
First NameMiddle InitialLast Name Suffix
Type of Membership (check one) Initiation Fee * Annual Dues**
Senior (SR) $1020 $816 ______
Boat Owner Age 29 or Older
OFFICE USE ONLY:
Senior Co-Owner (SACO) $1020 $612
Non-Boat Owner Age 29 or Older Date accepted______
Type______
Senior Associate (SA) *** $672 $294
Non-Boat Owner Age 29 or Older Annual dues_____
Single Handed (SH) $1020 $412
Boat Owner One Person Boat Percent used______
1st years dues______
Junior (JR) $498 $392
Boat Owner Age 14 to 28 Initiation fees______
Junior Co-Owner (JACO) $498 $256 1st years fees______
Non-Boat Owner Age 14 to 28
Parking fee______
Junior Associate (JA)*** $330 $140 ______
Non-Boat Owner Age under 29
Junior Full-time Student (JA/JRFS) 50% of Junior 50% of Junior
Ages 14 to 25 (must be in middle / high school or show proof of college enrollment)
* Initiation Fee may be paid quarterly for three years without a service charge. The first year starts with date of acceptance.
** Annual Dues may be paid quarterly with a service charge of $5.00.
*** Associate members may sail their own iceboat and/or sailboard at ISC.
FIRST YEAR MEMBERSHIP DUES STRUCTURE
Date of AcceptanceDues Payable
Before June 1st100%
Effective June 1st 80%
Effective August 1st 60%
Effective September 1st 40%
Effective October 1st 20%
Effective November 1stWaived
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Home Address______
City ______ST_____ Zip ______
Home Phone ______Cell Phone ______
email address ______
(needed for club business; if internet access is not available, let us know)
Employer/Business Name ______
Address ______
City ______ST ____ Zip ______Phone ______
Occupation ______
Preferred address for mailings regarding ISC: ______Home ______Office
Preferred phone number for receiving ISC phone tree messages: ______
Applicant’s birthdate:______Spouse’s Name: ______
Spouse’s email address ______
Names and birthdates of dependent children living at home:
______
______
Ifirst learned of the Indianapolis Sailing Club from:
______Open House ______Club member______
______Yellow Pages (book) ______Advertising______
______Yellow Pages (internet) ______Other______
______
I am acquainted with the following Indianapolis Sailing Club members:
1. ______2. ______
Class of sailboat owned or plan to purchase: ____ Thistle ____ Highlander ____ Y-Flyer
____ Lightning ____ Interlake ____ Snipe ____ Laser ____ Sunfish
Other: _____ Length _____ Width (Boats over 20 ft. to max of 27 ft. require prior approval)
Personal References:
Name ______Years Known ______Phone ______
Address ______City & ST ______
Name ______Years Known ______Phone ______
Address ______City & ST ______
Member sponsor: ______Date approved by ISC Board:______
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ADDENDUM TO ISC MEMBERSHIP APPLICATION
I hereby apply for the class of membership in The Indianapolis Sailing Club, Inc. (the “Club”) designated above, and if accepted, I agree to accept the benefits and obligations of such membership as provided by the Articles of Incorporation, the By-laws, the rules and policies of the Club as now in effect and as amended from time to time by the Board of Directors. If I am accepted into membership, I understand that the Club assumes no liability whatever for accidental or other physical injury or loss to me, my family, my guests, my boat, my car or other property. I understand that while the Club will make a good faith effort to provide safe facilities, it does not guarantee or warrant the safety or serviceability of the docks, equipment, hoists, gangplanks, grounds or clubhouse; and I and my family and guests use these facilities at our own risks.
Signature of Applicant: ______Date: ______
Printed Name of Applicant: ______
BELOW IS REQUIRED for applicants who have not attained the age of 18 years:
In consideration for the acceptance of the above named child for membership in the Indianapolis Sailing Club, Inc. (the “Club”), we, the parents of such child, do hereby undertake to guarantee the financial obligations of such child to the Club and covenant and agree to hold harmless the Club, its officers, directors and members from any and all liability for any claim, demand, suit or cause of action for damage or injury to such child arising out of such child’s participation in or in any manner associated with the Club’s sailing activities or use of the Club facilities. Additionally, we give permission to the Club, its officers, directors, staff and members to give any and all medical aid in the event of illness or accident in the event that we, or either of us, cannot be first reached.
This addendum is of continuing force during the minority membership of the above named child.
Signature and Printed Name of Parent or Guardian:
Signed:______Date: ______
Printed: ______Phone: ______
Signature and Printed Name of Parent or Guardian:
Signed:______Date: ______
Printed: ______Phone: ______
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