CAROLINA COAST SURF CLUB, INC.

PO Box 161
Sullivan's Island, SC 29482
www.carolinacoastsurfclub.org
MEMBERSHIP APPLICATION
PLEASE COMPLETE THIS APPLICATION AND MAIL IT WITH YOUR CHECK TO THE ABOVE ADDRESS. IF
APPLYING FOR A FAMILY MEMBERSHIP, HAVE EACH FAMILY MEMBER COMPETE A SEPARATE
APPLICATION AND ATTACH TO THE MAIN APPLICATION.
FULL LEGAL NAME:                                                                                                DATE OF BIRTH:                                   
MAILING ADDRESS:                                                                                                                                                                
HOME TELEPHONE NO:                                                 WORK TELEPHONE NO:                                                  
CELL TELEPHONE NO:                                                   E-MAIL ADDRESS:                                                            
APPLYING FOR: (CHECK ONE)              NOTE:  NEW MEMBER DUES ARE PRORATED ON A QUARTERLY BASIS
                FAMILY MEMBERSHIP: $100/YEAR (new membership includes two hats and two t-shirts)
               ADULT MEMBERSHIP: $50/YEAR (new membership includes one hat and one t-shirt)
               STUDENT MEMBERSHIP: $25/YEAR (MUST BE UNDER 21 YEARS OF AGE) (new membership includes one hat and one t-shirt)
T-SHIRT SIZE:                CAP SIZE: A         C         
MEMBERSHIP FEE:                                                                        
TOTAL AMOUNT DUE:                                       $                           
PLEASE TELL US ABOUT YOURSELF IN A FEW SHORT SENTENCES (FAMILY, WORK, HOBBIES, ETC).
ARE YOU WILLING TO HELP WITH CLUB FUNCTIONS OR PROJECTS?: YES           NO:           
BY SIGNING BELOW, I AGREE TO ABIDE BY ALL CLUB RULES AND REGULATIONS.
DATE OF APPLICATION:                                         
SIGNATURE OF APPLICANT                                                                                            
PRINTED NAME OF APPLICANT