Membership Application

Individual____ Family____

NAME_______________________________

ADDRESS____________________________

CITY/STATE__________________________

ZIP CODE_____________________________

PHONE_______________________________

WORK PHONE_________________________

FAX__________________________________

E-MAIL_______________________________

OCCUPATION__________________________

AGE__________________________________

FAMILY MEMBERS:

NAMES/AGES 1._____________________________

2._____________________________

3._____________________________

4._____________________________

5._____________________________

AVAILABILITY FOR RIDES/EVENTS:

MON-FRI___________________

SAT-SUN___________________

SPECIAL PWC INTEREST/TALENT_______________________________________

Safe Boating Course Completed? yes no

MAKE CHECK PAYABLE TO: TOLEDO WATER SPORTS INC.

2197 Shoreland Ave., Toledo, OH 43611

419-726-0646, 5pm – 9pm EST

$25.00 per year for Individual or Family

Revised 05/20/2002