Okee Bay Lodi, WI 53555
APPLICATION FOR MEMBERSHIP
NAME_____________________________________________________________
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ADDRESS__________________________________________________________
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HOME PHONE______________________________________________________
CELL PHONE_______________________________________________________
E-MAIL____________________________________________________________
YEAR AND DESCRIPTION OF CORVETTE/S:
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I HAVE READ AND UNDERSTAND THAT THE COLUMBIA COUNTY CORVETTE CLUB U.A.
IS AN UNINCORPORATED ASSOCIATION REGISTERED WITH THE STATE OF WISCONSIN.
THE CLUB NOR THE OFFICERS NOR THE MEMBERS ARE LIABLE FOR ME OR MY
ACTIONS. THE CLUB CARRIES NO INSURANCE AND I UNDERSTAND THAT I AM
RESPONSIBLE FOR MY OWN INSURANCE.
SIGNED___________________________________________DATE______________________
NEW MEMBERS PLEASE SEND $25.00 MEMBERSHIP FEE TO THE ABOVE ADDRESS OR GIVE IT
TO A CLUB OFFICERS WHEN ATTENDING AN EVENT.