Moorage
Reimbursement Form for Reciprocal Clubs
Reciprocal Member Information
Reciprocal Yacht Club:
________________________________________________________________________
Member First and Last Name:
___________________________________________________________________
Mailing Address:
_____________________________________________________________________________
City: ____________________________ State / Region: __________________
Postal Code: _________________
Contact Phone: ________________________
Vessel Information
Name of Vessel: __________________________________________
Length: __________ Sail_____ Power_____
Model: ______________________________________________ Registration #:_________________________
Visit Information
Date of Visit: ____________________________ Amount paid excluding
electrical charges: $_________________
Limitations
Reciprocal moorage is at the
Shilshole Bay Marina guest dock and is limited to one night’s stay, per boat,
per calendar year. Electricity will be charged at the going rate.
A copy of the marina receipt
and proof of current reciprocal club membership must be included.
As a member in good standing
with a current participating yacht club I agree to the above reciprocal moorage
rules and request reimbursement from
Member Signature: ____________________________________________
Date Signed: _____________________
|
Mail completed form, copy of receipt and proof of
current membership to: Shilshole Bay Yacht Club 2442 NW Market Street Box 98 Seattle, WA 98107 |
FOR SBYC USE ONLY
Date request received:
_______________________ Accepted _________
Rejected ___________ If rejected, date rejection notice sent and reason Payment Sent Date: _________________ Amount: $_____________ |