Please check one:    ___ New Member             ___ Renewal            Member since (mm/yy): ______

□   Check here if you would like to read the Bay Piper on line and save CBTSC printing and mailing costs!

Name:______________________________________________   Name:________________________________________________ 

Address:__________________________________________________________________________________________________

City:____________________________________________________________ State:__________________ Zip:________________

 Boat Model:____________________________ Boat Name: _________________________ Hull #: __________ Year Built:__________

 Boat Location    Name of River:____________________________      Name of Marina:____________________________

                                         Home: (___) - ____________  Work: (___) - ___________      Cell Phone: (___) - ____________

Please make Check Payable to: CBTSC

Dues: - --- - $40.00 
Burgee: - - - $22.00