KILLDEER ISLAND CLUB

191 Killdeer Island Road

Webster MA 01570

APPLICATION FOR DOCK AND WATERCRAFT

Name__________________________________________________________________

Summer Address_________________________________________________________

Mailing Address (if different)_______________________________________________

Phone Number______________________email address__________________________

Winter Address__________________________________________________________

Mailing Address (if different)_______________________________________________

Phone Number______________________email address__________________________

Homeowner’s Insurance Binder  (Attach Copy)___________________

Watercraft Information

            Make                            Model               Color                Registration Number

1._____________________________________________________________________

2._____________________________________________________________________

3._____________________________________________________________________

4._____________________________________________________________________

Boat Insurance Binder  (Attach Copy)___________________________

Signature______________________________________________________________

Please print name________________________________________________________

Date___________________________________________________________________

Please enclose a check for $125 for each watercraft to be docked.  Make checks payable to Killdeer Island Club.  Mail applications to Killdeer Island Club, 191 Killdeer Island Road, Webster  MA 01570   Attention:  Ron Danforth

Dock Registration Number___________________________

                                           (Shall Be Issued Upon Approval)

The 2009 boating season is fast approaching and boaters will be looking for dock space.  Anyone who had a dock in 2008 will get first choice for the same spot for 2009.  Dock fees and member-ship dues must be paid before your docks can be placed in the water.  We require that you pay your club dues ($35.00 per member) and $125.00 for each gas-powered watercraft by April 30th.  If your dues and boat fees are not paid by April 30th, you may lose your dock spot.  The only people allowed to store their docks on club property in the off season are those with paid up boat fees.  You are also reminded that docks should be stored in an orderly manner.

If you have any questions, please call Ron Danforth at 508-737-4942.