Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Summer Phone *

(###)

###

####

Winter Phone

(###)

###

####

Boat on Pop-its ($500)

Boat on Pop-its ($500)

Boats over 23' on trailer ($350)

Boats over 23' on trailer ($350)

Boats under 23' on trailer ($250)

Boats under 23' on trailer ($250)

Trailer alone ($200)

Trailer alone ($200)

Sailboat under 18' ($175)

Sailboat under 18' ($175)

Canoe, Paddleboard(s), Dinghy under 8' ($75)

Canoe, Paddleboard(s), Dinghy under 8' ($75)

I certify that all of the above information on this contract is accurate and current. I understand that the care and maintenance of my boat is my sole responsibility and that the Block Island Club, its Board of Governors, agents and employees are not responsible for any loss, theft or damage to the boat its parts or accessories or personal property of the owner or guests. My boat hull and any large, removable parts have been marked with my last name. I understand and agree that I am responsible for any loss or damage to persons or property as a result of my activities. I agree to indemnify and hold harmless the Block Island Club, its Board of Governors, agents and employees from any claims arising out of my actions or the actions of others I have brought to the Club. I understand and agree that Block Island Club, it Board of Governors, agents and employees are not responsible for bailing my boats after a rainstorm or after wind driven waves have caused it to take on water, nor are they responsible for moving the boat or altering the manner in which it is secured to the pier in the event of a storm, squall or wind shift. I acknowledge that in the event of a major storm event, such as a hurri- cane, I am responsible for moving my boat from the Club pier and, if necessary, having it hauled. If, in the Club's judgment, my boat must be hauled to protect Club property and the property of others, and the Club undertakes to have my boat hauled, I will reimburse the Club for such cost. I understand that the Club is used for sailing and swimming lessons, and for recreational sailing and swimming. I will keep clear of sailors and swimmers, and will operate at a no-wake speed within the area marked by Block Island Club buoys. I also understand that personal watercraft (jet skis) are not permitted at the Block Island Club. I understand and agree that the Block Island Club is a family club and that my guests and I will behave appropriately at all time. I understand and agree that alcohol is prohibited from the docks and dock areas. The Block Island Club reserves the right to suspend or terminate a person's storage for any reason, including, but not limited to, unsafe operation of the vessel, damage to Block Island Club property and/or violation of Block Island Club rules. *

I have read the above agreement and agree and understand the terms listed above