One-Year Leave Application

Member Information

Member Number *

Primary Member *

First

Last

Email *

Cell Phone *

Leave Effective Date *

KYC Fiscal year runs from Nov 1 to Oct 31.

Yes, I am aware that:

Privileges on hold *

the following membership privileges will also be placed on hold until my membership is reinstated: Key Cards, Dining privileges, access to KYC events, Boat Club & Rentals, Paddle Club & Rentals, Reciprocal privileges, member discounts at the Galley.

Dependents *

upon approval, my membership, along with privileges for my spouse and dependents (if applicable) will be on hold until my membership is reinstated.

Moorage *

moorage is relinquished, as is my spot on any moorage waitlist

Newsletter *

I will continue to receive the KYC Newsletter to keep up with the Club’s happenings. my leave is for myself, the primary member, as well as spouse and all dependents

Reinstated *

I can apply to have my membership reinstated at any time during my leave

While on Approved Leave

Do you have Moorage? *

Yes
No

Slip Number *

Signatures

As a Member of the Kelowna Yacht Club, you agree that all particulars shown in this electronic application are correct.

Signatures – Acknowledgements *

I, as the Primary Member, and by signing this form, agree that prior to the leave being approved, a fee of $250.00 plus tax must be paid along with any balance owing on your account.

Signature *

Clear Signature

Full Name: *

By typing out my full name, I acknowledge that I declare all particulars shown are correct; I have read, understand, and agree to the terms and conditions stated in this electronic form. I further understand that a signature card must also be submitted for reference and that this electronic form and the submitted signature card will have the same legal effect. Additionally, I confirm that I am the Primary Member of the account and that I have the authority to complete this form on behalf of the membership.

Office Notes

5-Day Forecast

Member Information

Yes, I am aware that:

While on Approved Leave

Moorage Cancellation

Signatures

Stay in the loop.