2020 Membership/Dock Form

COON LAKE COMMUNITY AND SENIOR CENTER 2020 MEMBERSHIP/DOCK SPACE FORM

NAME                        ____________________________________________DOCK SPACE#(S) _____________________________

PARTNER/SPOUSE  ____________________________________________AMOUNT PAID _______________________________

ADDRESS ON CLB   _______________________________________________________________________________________

Residence Address (if different from above)   __________________________________________________________________

HOME PHONE   ______________________________________   CELL PHONE   _______________________________________

EMAIL ADDRESS     _______________________________________________________________________________________

SIGNATURE              _______________________________________________________________________________________
The Coon Lake Community & Senior Center is a body of people who are concerned with the quality of life on Coon Lake Beach.  We provide support for local concerns, maintain and organize the Dock Space Program and maintain the Center (Clubhouse).  Memberships are available at volunteer (requires a minimum of 10 volunteer hours annually) and non-volunteer levels, with or without a dock space, but you MUST be a member in order to obtain a dock space.

As a member, you have an option to pay for, maintain and use up to two dock spaces.  While one space is available for every requesting resident in good standing, up to one additional dock space may be issued based on availability.  The additional space requires a payment at the non-volunteer level.  Please indicate the number of dock space(s) you would like to request by placing an “x” in the box directly to the right of the corresponding itemand enclose payment for the correct amount as outlined in the cost of membership section.

 

 

1 Person Membership
No Dock Space

 

2 Person Membership No Dock Space

 

Dock Space 1

 

Dock Space 2

 

Dock Space 3

 

Volunteer

 

30

 

50

 

100

 

+200

 

+200

 

Non-Volunteer

 

60

 

100

 

200

 

+200

 

+200

 

 

I/WE WILL ATTEND MEMBERSHIP DINNER MAY 28th  _________YES  _________NO    ____________HOW MANY


If you are interested in receiving a receipt for your membership, please indicate so and provide an email address for the receipt to be sent to.  All receipts will be sent electronically.

Agreement with and adherence to the Coon Lake Community & Senior Center, Inc.’s Dock Space Rules and Regulations for 2020 is required.  By signing this agreement, you agree to abide by all rules and regulations as stated.

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.

The Coon Lake Community & Senior Center hereby grants the above named party(ies) the permission to use the dock space(s) designated above for a period of year from May 1, 2020 to April 30, 2021.

THIS AGREEMENT MUST BE RENEWED ANNUALLY TO MAINTAIN YOUR DOCK SPACE PRIVILEGES.  PLEASE NOTE:  IF THIS FORM IS NOT COMPLETED, SIGNED, AND RECEIVED BY  MAY 1, 2020 YOUR DOCK SPACE(S) CAN BE DECLARED OPEN.

For questions regarding membership, please contact any Officer or Director.  For questions regarding dock spaces, please contact Dale Voltin at (612) 718-6565.