ARMDALE YACHT CLUB

APPLICATION FOR MEMBERSHIP

75 Burgee Run, Halifax, Nova Scotia B3P 0C9 Phone: 902.477.4617 Fax 902.477.0148

This Form Must Be Completed in Full

SECTION 1 – PERSONAL INFORMATION

Name _________________________________________________________________________________________________
Address (street, city, province, postal code) ___________________________________________________________________
_______________________________________________________________________________________________________
Phone (home) (work) (cell) _________________________
Gender* Date of Birth*__________________________________________________
Employer (name of company)__________________________________Occupation____________________________________
Associate Name (spouse/partner) ___________________________________________________________________________
Associate Gender*__________ Associate Year of Birth* _____________________________
*Provided to Sail Nova Scotia, of which you become a Member when you join a yacht club in NS. Sail NS uses this information
for statistical purposes and may also provide to the provincial government when applying for funding.

Member’s Emergency Contact (typically not the Associate) ___ _______________________________________

Relationship to Member___________________________________________________________________________________
Phone (home) (work) (cell) ________________________
AYC maintains two e-mail addresses per Member on file:
E-Mail 1 receives all e-mail correspondence, including Invoices. Note: Invoices are sent by e-mail only.
E-Mail 2 is used if there is an issue with the Primary E-mail &/or to send the weekly ‘eNews’ to the Member’s Associate.
It is the Member’s responsibility to notify the Club Office of any e-mail changes.

E-Mail 1 (Primary for Member)_ ___________________________________________________________________________

E-Mail 2 (Alternate for Member, or for Associate)________________________ ______________________________________

SECTION 2 – TYPE OF MEMBERSHIP

Please check the Membership status you are applying for:
 Senior (Boat Owner 25+)  Intermediate (19–24)  Junior (12-8)  Social (Non-Boat Owner)  Outport  Affiliate
Have you ever been a Member of AYC?  No, first time applicant  Yes; Membership Type ________________________
Have you ever been a Member of another Yacht Club?  No  Yes, Current  Yes, Past
Name of Club(s) & please indicate the year(s) during which you were a Member of each Club you list:
_______________________________________________________________________________________________________

Do/did you serve on Management?  No  Yes; position(s) held: ___________________________________________

OFFICE USE  Notice Posted for 7 days  Applicant Screened  Approval Granted  Insurance Proof
Member # ____________________________Date Member Became Active _____________________________________________________
AYC Office_______________________________________________ _________________Date_____________________________________
Vice Commodore (also the Membership Chair)_________________________________ Date ____________________________________

Date: April 1, 2019 Page 1 of 3

SECTION 3 – BOAT INFORMATION

 Power  Sail Boat Name (or Registration # if no name) _____________________________________________

Boat Make and Type____________________ _____________________________________________________________
Hull Colours_________________________Length____________Beam____________Draft_________ Weight_____________
Are you the sole owner of this boat?  Yes  No If no, name of co-owner(s):_____________________________________
Dinghy:  Yes  No Kayak:  Yes  No Boat Insurance Expiry Date: ____________________________________
Note: Proof of current active Boat Insurance Policy must be provided with this application.
All boat owning Members must provide annual proof of Protection & Indemnity Liability Insurance with Membership Dues.
SECTION 4 – BOAT SERVICES REQUESTED

Storage:  Boat Cradle  Boat Trailer  Storage Locker  Spar Storage; Length of Spar: ______ feet  None
Winter Storage:  Wet  Dry  None
Summer:  Mooring  Marina  None Launch/Haul Out:  Yes  No
Summer Power:  15 amp  30 amp  50 amp;
Winter Power – self-identify power usage:  None  Light (i.e. light bulb)  Moderate (i.e. heater); watts: ________
 Heavy (i.e. heater & appliances); Heater Wattage: ________; Appliances (specify): ________________________________
SECTION 5 – SPONSORS
Note: Two AYC Members (except Affiliate and Outport) in good standing must sign this application. Associate Members
may sign; however, a Member and their designated Associate may not sign the same application.
If you do not have sponsors, you must agree to take part in an interview conducted by the AYC Membership Committee.
I agree to be interviewed:  Yes  No; OR

Sponsor 1 Name Phone (h) _(w) (c)________________

Length of Acquaintance________________________ Signature___________________________________________________
Sponsor 2 Name Phone (h) __(w) (c)_______________
Length of Acquaintance________________________ Signature___________________________________________________
SECTION 6 – PAYMENT & CREDIT CARD INFORMATION
 AUTO BILLING Lump Sum – your credit card number that is on file will be charged automatically within 5
– 7 days from the invoice date for the full amount of your invoice.
 MONTHLY PAYMENT (BUDGET) PLAN Most of your yearly fees* are combined and divided into 10 payments to be paid by
(FOR SENIOR/INTERMEDIATE/ LIFE either credit card or post-dated cheques. The Office processes payments at the beginning
MEMBERS ONLY) of each month (March - December). You can sign up for this plan at the beginning of each
I AM PROVIDING: year; deadline is January 31 of the current billing year. *Annual Membership, Sail Canada
 CREDIT CARD # Dues and Food & Beverage Credit are due upon receipt. Your credit card on file will be
processed within 5 – 7 days of the Invoice date.
 POST DATED CHEQUES

Credit Card Use Authorization: Card Number _________Expiry______________  Visa  MasterCard

Name on Credit Card______________________________________________________________________________________
Cardholder Signature to Authorize Billing Charges_______________________________________________________________
Initial Entrance Fee & Other Applicable Dues/Fees enclosed. Amount $____________________________________________
 Cash  Cheque  Credit Card as Noted Above  Other (specify): __________________________________
You must be in good standing with up-to-date account and required documents at the AYC Office to have your vessel launched
or hauled. All Invoices due & payable upon receipt. Overdue accounts collected per AYC ‘Policy on Receivables and Collections’.

Date: April 1, 2019 Page 2 of 3

SECTION 7 – MEMBER RELEASE AND INDEMNIFICATION AGREEMENT
This Agreement is made between ARMDALE YACHT CLUB, a body corporate, hereinafter called the “Club” and the person in ‘Name’ of
Section I of this application, hereinafter called the “member”.
Witnessed that in consideration of the Club permitting the undersigned to use its yachting facilities and services and in payment of the sum
of One Dollar ($1.00) by the Club member and other good and valuable consideration (the receipt whereof is hereby acknowledged), the
Member:
(1) Waives, releases and forever discharges the Club, its servants, employees, or agents of and from all manner of action, causes of action,
accounts, claims or demands, of whatsoever kind which against the Club, the Member ever had, now has or which the Member, his
heirs, administrators, executors, successors or assigns will have, for or by reason of any cause, matter or thing, and howsoever arising
and whether by negligence or otherwise and more particularly, but not so as to restrict the generality of the foregoing , from all claims,
demands, manners of action, accounts or causes of action arising out of or in any way incidental to the launching, hauling, storage (wet
or dry), mooring maintenance or movement of any yacht owned by the Member by the Club, its servants, employees or agents.
(2) Agrees to indemnify the Club, its servants, employees or agents against any loss, damage or injury which they may suffer by reason of
any acts or omissions of the Member, and hold the Club, its servants, employees or agents harmless from all claims made upon them
by reason of or arising out of launching, hauling and storage (wet or dry), mooring maintenance or movement of any yacht owned by
the Member.
(3) Agrees that the Club, its servants, employees or agents shall be under no responsibility whatever to the Member in respect to property
of any kind or description of the Member, which is located on or about the lands, marinas or waters, leased by or surrounding the Club
and including (without restricting the generality of the foregoing) any loss or damage sustained due to negligence or failure to fulfill
any express or implied obligation to use case by the Club, its servants, employees or agents.
(4) Agrees that the word Yacht shall include its hull, machinery, fittings, hardware, rigging, sails, masts and appurtenances of every kind
and description, its cradle, mooring and tender.
(5) Agrees that the yard crew may move yachts or vessels as they deem necessary without giving prior notice or obtaining the consent of
the owner.
(6) Agrees that an indirect interest in property shall include but not be limited to any property owned by his spouse, immediate family,
crew member or any company in which the Member, spouse or direct family member holds shares.
(7) Agrees that this agreement shall remain in force until such time as it is expressly waived or discharged by the Club.
(8) This agreement shall endure to the benefit of and shall be binding on the parties hereto and their respective heirs, executors,
administrators and assigns.

Signed and Delivered in the Presence of

___________________________________________________________________________________________________________________
Witness Signature Witness Name (printed in full) Date
___________________________________________________________________________________________________________________
Member Signature Date
Important Note: Each Yacht owner should contact his Hull Insurer before entering into this Release and Indemnification Agreement, as the
failure to do so may result in the Insurer declaring the Policy void.

SECTION 8 – APPLICATION CHECKLIST & SIGN OFF

1. I hereby apply for Membership at AYC, and certify that the above information is complete and correct.
2. If accepted as a Member, I agree to abide by AYC Bylaws, Yard Rules, House Rules and other AYC Policies as amended periodically.
3. I understand that AYC reserves the right to post, via electronic and paper media, Club activity-related photos, names of Members and
Boats, and notices of various activities that take place throughout the year. These may include awards, recognition, advertising, events
or any other Club-related business.
4. I have attached a copy of my current boat insurance policy.
5. I have provided a Credit Card # to be kept on file and charged according to the approved Dues/Fees Schedule or any Monthly Payment
Plan I may opt for, and any default is to be automatically placed on that Card.
6. PERSONAL INFORMATION PROTECTION AND ELECTRONIC DOCUMENTS ACT (PIPEDA): AYC collects personal information such as
name, address, contact information, and other information pertaining to your Membership. Information retained by the Club is used
for Membership records and for the purpose of billing and internal communications. Published material, such as AYC’s Membership
Directory (located in the Members Only Area of the AYC web site) and Welcome New Members column (in the ‘eNews’), is solely for the
use of the individual Members and not intended for outside commercial purposes. I consent for AYC to collect, use and disclose your
information as indicated above.

Signature_______________________________________________________________________________Date________________________

All applications are posted on the Club house Bulletin Board for seven days and subject to Committee of Management approval. The
approval process can take up to 30 days. AYC reserves the right to refuse any application.

Date: April 1, 2019 Page 3 of 3