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Please fill out as much information as possible as accurately as possible.
Yacht Club Name: (Required Input)
Year Club Organized:
Club GPS Coordinate: Lat: Long:
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Submitter Information:
Full Name: Job Title: Email: Phone:
Yacht Club Information:
Yacht Club NAME: Yacht Club MAILING Address: Yacht Club CITY: Yacht Club State or Country: Yacht Club ZIP: Yacht Club PHYSICAL Address: (if different than above mailing address) Yacht Club PHONE Number: Yacht Club FAX Number: Yacht Club WEBSITE Address: Name of BODY OF WATER that the Yacht Club is located on:
Average Yacht Club harbor depth in feet @ (MLLW) feet
Does Club Monitor a VHF marine channel? yes no Channel(s)
Does Club have Wi-Fi (wireless internet access) yes no
Yacht Club Facilities Information: (Check all that apply)
Facilities Hours
Clubhouse - OPEN on: M T W T F S S
Holidays WeekendsDaily
Galley - OPEN on: M T W T F S S
Galley - OPEN for: Breakfast Brunch Lunch Dinner
Special Events Cruise Ins
Bar - OPEN on: M T W T F S S
Does Club Bar have jukebox music? yes no
Is it a Members ONLY bar? yes no
Membership Ratio: % Sail boaters % Power boaters % Other
Reciprocity (Check all that apply)
Reciprocal Status Have guest call club for reciprocal information Reservations required
Please detail reciprocal information below:
Guest Docking Information (Check all that apply)
Guest Dock Available Guest Slips Available Municipal Docking Moorings
Guest Dock/Slip has electric
20AMP 20/30 AMP20/50 AMP30 AMP 30/50 AMP Other: AMPS
Guest Dock/Slip has water Guest Moorings Available
Pump-Out Station (available to Guests)
Fuel Dock available with:
Regular Fuel Regular Plus Fuel Premium Fuel DieselPropane
Parking availability:
At Club Members Only NearbyWithin Walking Distance More Than 1 Mile away
Public Phone: At Club NearbyWithin Walking Distance More Than 1 Mile away
Restaurant: At Club Within Walking Distance More Than 1 Mile away
Grocery Store: Nearby Within Walking Distance More Than 1 Mile away
Ice At Club Within Walking Distance More Than 1 Mile away
Mini Mart: Nearby Within Walking Distance More Than 1 Mile away
Bait and Tackle: Nearby Within Walking Distance More Than 1 Mile away
Laundromat: At Club Within Walking Distance More Than 1 Mile away
Showers: At Club Within Walking Distance More Than 1 Mile away
Restrooms: At ClubNearby Within Walking Distance More Than 1 Mile away
Boat Launching Ramp: Nearby Within Walking Distance More Than 1 Mile away
Club Hoist Weight Limit lbs
Hotel: Nearby Within Walking Distance More Than 1 Mile away
At the Club: Pool Spa Exercise Room Tennis Courts
Camp Sites: Nearby Within Walking Distance More Than 1 Mile away
RV Sites: At Club Members Only Within Walking Distance More Than 1 Mile away w/Full Hook ups
Pets: Pets OK In restricted areas only Member Pets only No Pets
Nearby Services: (Check all that apply)
Small Boat Rentals
Houseboat Rentals
Boat Storage
Boat Repair
Boat Engine Repair
Marine Store
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