Name *

First Name

Last Name

Secondary Name

First Name

Last Name

Emergency Contact

First Name

Last Name

Phone *

(###)

###

####

Secondary Phone

(###)

###

####

Members Directory (for long term transients only) *

Would you like to be included in our Members Directory? If so, the following information will be shared with other members. (Name, Phone Number, Email, Pet Name, and Slip Number)

Yes

No

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Type *

Powerboat

Sailboat

Insurance Expiration Date *

MM

DD

YYYY

Desire to be a Live Aboard *

Yes

No

Requested Check In *

MM

DD

YYYY

Requested Check Out *

MM

DD

YYYY

I agree to email info@sa-yc.com with a photo of my vessel *

You will not recieve a contract if you fail to submit a photo of your vessel.

Yes