Print this page, fill in the required information, send U.S. Dollars or Mexican Pesos only. No checks and MAIL TO:

Club Cruceros de La Paz, APDO Postal No. 366, La Paz, B.C.S. MEXICO 23000

20th Anniversary    Burgee

Burgees available at $15 each. See Below

CLUB CRUCEROS MEMBERSHIP APPLICATION

 New Renew Date Amount Paid
 Name Card#
 Name Card#
 Boat Name or Call Sign
 Mailing Address
 E-Mail Address
 Telephone/Fax Numbers
 Emergency Contact  Relationship
 Address Phone
 I will donate time to the club for:
 I will donate ( ) US$ ( ) Pesos above the membership fee for:

Send me a Club Burgee ( ) US$15.00 - Include payment for Burgee/T-Shirt/Cap with Dues.

Send me a Club T-Shirt ( ) US$12.00 ( ) S ( ) M ( ) L ( ) XL

Send me a Club Cap ( ) US$8.00 (ajustable size baseball cap style).

Please Send U.S. Dollars or Mexican Pesos only.

No checks

MEMBERSHIP DUES : $10.00 U.S. PER PERSON PER YEAR