The deadline for early renewal is 31 January 2020.
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In #1 below please indicate your membership status - are you a current or a new member?
(1) Status *
(Answer required)
Personal Information
This form allows you to renew your CBSA membership for 2020 or apply for new membership. With a club membership you can participate in CBSA races, activities and social events. Club members can also pay for boat storage space in the compound at Cadboro Bay (subject to availability).

- If you have any questions about membership, please email our membership director at:
- To inquire about boat storage, please email our compound boat placement director at:
- For any queries about this form, please email our commodore at:
(2) Family name *
(Answer required)
(3) Given name *
(Answer required)
In #4 below please repeat your name and include your street number, street, city, and postal code so we may generate a mailing label. Enter this information as you would like to see it on a label (see example below). Note: To move to a new line when entering your address, please press your enter key.

George Vancouver
Legislature Rooftop
Victoria, BC
V8N 4G1
(4) Mailing address *
(Answer required)
(5) Email address *
(Answer required)
(6) Phone number *
(Answer required)
(7) Spouse name
(Optional - to skip leave blank).
(8) Spouse email
(Optional - to skip leave blank).
(9) Spouse phone
(Optional - to skip leave blank).
The Club will send communications to the email address provided in #5 above. If - in addition - you would like communications sent to a second address, please enter that address in #10 below.
(10) Email #2
(Optional - to skip leave blank).
To help the Club stay in touch please provide us with a back-up contact in #11 below. This is someone we would communicate with in the event we cannot reach you with the information you provided above. Please include a NAME plus a TELEPHONE NUMBER and/or an EMAIL ADDRESS.
(11) Backup contact *
(Answer required)
If you are a full-time K-12 or post-secondary student you are eligible for a Student Membership, for which the annual dues are $40. To apply, please indicate your institution and student number below (this information is required).
(12) Institution
(If not applicable leave blank)
(13) Student #
(If not applicable leave blank)
In #14 below please answer the following: Are you Coast Guard accredited to use the Club zodiac, i.e., do you have a Pleasure Craft Operator Card (PCOC) number? If ``Yes`` please record your PCOC number in #15 below.
(14) CG Accredited *
(Answer required)
(15) PCOC #
(If not applicable leave blank.)
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