MEMBERSHIP APPLICATION

CAPE CORAL TARPON HUNTER'S CLUB

MEMBERSHIP APPLICATION

Complete and mail with payment to: Cape Coral Tarpon Hunter's Club

P.O. 100842, Cape Coral, FL. 33910

Date:____________

Name:_____________________________________ Date of Birth:________

Show name as you want it on roster

Address:______________________ City:____________ State:___ Zip:______

Home Phone:_____________ Cell:______________ Other:_______________

E-Mail Address:____________________________

Annual Dues: ( ) $40.00 Single ( ) $45.00 Family ( ) Check #______( ) Cash

Family Memberships

Spouse Name:_________________________________Date Of Birth:________

Dependent Children or Grandchildren Under 18 years of age on March 1

Name:_______________________________ DOB:______ Relationship:______

Name:_______________________________ DOB:______ Relationship:______

Name:_______________________________ DOB:______ Relationship:______

Name:_______________________________ DOB:______ Relationship:______

Name:_______________________________ DOB:______ Relationship:______

( ) Renewal ( )New Member: How did you hear about club? ______________ _________________________________________________________________

Boat Name: __________________________ Do you have a VHF Radio? _____

Sponsored by: ___________________________

Board Approved Date: _____________________

Rev:10/20/2011