Dock Space Form

Coon Lake Community & Senior Center 2017 Dock Space Agreement

 

 DOCK SPACE #(S) ­_____________________

 

  AMOUNT PAID   ______________________

 

NAME_______________________________________   PHONE ______________________________

 

EMAIL_____________________________________________________________________________

 

COON LAKE ADDRESS________________________________________________________________________

 

RESIDENCE ADDRESS_________________________________________________________________________

 

Agreement with and adherence to the Coon Lake Community & Senior Center, Inc.’s Dock Space Rules and Regulations for 2017 is required. By signing this agreement, you agree to abide by all rules and regulations as stated.

 

The Coon Lake Community and Senior Center hereby grants the about named party(ies) the permission to use the dock space(s) designated above for a period of one year from May 1, 2017 to April 30, 2018.

 

By signing this agreement you are verifying that you have current liability insurance in place to cover any

Claim against your dock and any personal property on your assigned dock space(s) and will not hold

CLC&SC liable for any such claim.

THIS AGREEMENT MUST BE RENEWED ANNUALLY TO MAINTAIN YOUR DOCK SPACE PRIVILEGES AND IS NOT TRANSFERABLE.

 

 

Signed___________________________________________________           Date__________________________

 

 

PLEASE NOTE:  If Membership Agreement Form and Dock Space Agreement Form are not completed in full, signed and received with payment by May 1, 2017, dock space(s) may be declared open.