Lake Kegonsa Sailing Club
Membership Application

You do not have to enter all the information requested, however, we would appreciate it if you would supply most if not all the answers. We will build a database so we may better serve you with activities, information and resources that fit your wants and needs.

WE WILL ABSOLUTELY NOT SHARE THIS INFORMATION WITH ANY OUTSIDE PARTIES, ORGANIZATIONS OR BUSINESSES WITHOUT YOUR PERMISSION.

* Required

*Last Name:

*First Name, MI:

Spouse Name:

Other Names:

*Email Address:

2nd Email Address:

Telephone:

2nd Telephone:

Street Address:

*City:

*State:

*Zip Code:

*Country:

Type(s) of
Sailboat(s):

Please list all sailboats and sailboards in order of size with longest first.

Boat 1

Make/
Description:

Hull Color:

Sail Number:

Boat Name:

Spinnaker Color:

Skipper's Name:

Boat 2

Make/
Description:

Hull Color:

Sail Number:

Boat Name:

Spinnaker Color:

Skipper's Name:

Boat 3

Make/
Description:

Hull Color:

Sail Number:

Boat Name:

Spinnaker Color:

Skipper's Name:

Boat 4

Make/
Description:

Hull Color:

Sail Number:

Boat Name:

Spinnaker Color:

Skipper's Name:

Boat 5

Make/
Description:

Hull Color:

Sail Number:

Boat Name:

Spinnaker Color:

Skipper's Name:

Ice Boat(s):

Please list multiple boats in order of class with biggest first.

Boat 1

Boat 2

Do you have a power boat?

Yes
A pontoon Boat - Yes
No

Would you like to crew on a sailboat?

Yes
No

Do you want crew for your boat?

Yes
No
Sometimes

Would you be willing to be the Committee Boat for a race?

Yes
No

Would you be willing to crew on a Committee Boat for a race?

Yes
No

Would you attend "Basic How To" sailing seminars?

Yes
No

Would you attend "Advanced How To" sailing seminars?

Yes
No

Would you attend "Racing How To" sailing seminars?

Yes
No

Are you interested in combining sailing and social gatherings such as Sail Arounds with a social stop?

Yes
No

Are you interested in social gatherings during the "off season"?

Yes
No

Do you have a talent or service that you would volunteer to the club? If yes please explain.

I would like to receive the LKSC Newsletter.

Yes
No
If "Yes", please Click Here to Subscribe
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I would like to be a member.

Annual dues are:
$35 for family membership
$25 for single membership
$10 for single child membership
(April 1 - March 31)

I understand I should be a member to fully participate in LKSC races and regattas.

Please mail your membership dues to:
Lake Kegonsa Sailing Club
P.O. Box 75
Stoughton, WI 53589

$35.00 Household Membership
$25.00 Individual Membership
$10.00 Child Membership

I/we agree to assume full responsibility for any and all injuries or damages that may occur to me/us and my/our property as a result of the inherent risks associated with sailing and windsurfing. I/we agree to release, on behalf of myself/ourselves, family, heirs, and assigns, the Lake Kegonsa Sailing Club, Inc., and its officers and members, from any and all liability for damages to or loss of personal property, loss of money, sickness, injury or death which might occur while participating in LKSC activities.

By checking this box I agree to the statement of responsibility above and decree that this is my electronic signature accompanied by my legal name on this application.