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Channel Islands Women's Sailing Association - Application for NEW Membership
Use this form for NEW membership only. For renewal, follow the "Renew Your Membership" link.
Select Membership Level *
Required
First Name *
Your answer
Last Name *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Home Phone
(xxx) xxx-xxxx
Your answer
Mobile Phone *
(xxx) xxx-xxxx
Your answer
Email Address *
This is our primary method of communication with you.
Your answer
Emergency Contact
(Name, relationship, and phone number)
Your answer
Birthday
(Month and Day)
Your answer
Are you a BOAT OWNER?
If a boat owner, what is the MAKE, YEAR and NAME of your boat?
Make, Year, "Name"
Your answer
If a boat owner, what is the HARBOR and DOCK LOCATION of your vessel?
Your answer
Would you be willing to take CREW on YOUR BOAT?
If YES, for:
Are you interested in crewing on a boat?
If YES, for:
What is your SAILING ABILITY?
What is your SWIMMING ABILITY?
CIWSA COMMITTEES
Serving on a committee is a great way to be involved, get to know other members, and have fun. PLEASE JOIN IN!!
Are you willing to serve on any of the following committees?
Thank you for joining the CIWSA!
To complete your membership application, please submit your due payment as well as print and complete the applicable Liability Release Waiver(s) [add website links to waivers].

Payment options include PayPal https://paypal.me/pools/c/81rzKpg9pJ or snail-mail (CIWSA, 3600 Harbor Blvd, PMB #268, Oxnard, CA 93035). Signed waiver(s) may be sent via email (CIWSA.membership@gmail.com) or snail-mail.

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