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First Name  
Last Name  
Address
City
State/Province
Zip/Postal Code
Country

Phone Number 
Work Number 
Cell Number 
E-mail Address 

Birth Date (mm/dd/yyyy)
Gender Male Female
US SAILING Number  
Yacht Club *
One Design Demo Fleet Name/Number
Boat Type
Sail Number
Hull Number:
Boat Name:

Membership Benefits:

One Design Demo Memberships are for the membership year January 1 through December 31.



Membership Type :



 

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