Newburyport Yacht Club 300R Merrimac Street Newburyport, MA 01950         (978 ) 463-9911        VHF Channel 71

Member Parking Pass Registration Form

NEWBURYPORT YACHT CLUB
Member Parking Pass Registration Form

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First Name:
Last Name:
Date:
Slip #:
Cell Phone:

Vehicle One

Year/Make/Model/Color:Vehicle One
Plate Number:Vehicle One
Picture of Vehicle Onesnap a pic and upload it with your smartphone, tablet or computer
Click to upload a picture

Vehicle Two

Year/Make/Model/Color:Vehicle Two
Plate Number:Vehicle Two
Picture of Vehicle Twosnap a pic and upload it with your smartphone, tablet or computer
Click to upload a picture

Vehicle Three

Year/Make/Model/Color:Vehicle Three
Plate Number:Vehicle Three
Picture of Vehicle Threesnap a pic and upload it with your smartphone, tablet or computer
Click to upload a picture

By signing below, I agree to the following: 


I will be occupying the above referenced slip this season, and understand that I am entitled to one (and only one) Parking Pass. However, I want the option of parking any one of the vehicles listed below in the Members Only Parking area.


I understand that I am not to loan or give my Parking Pass to another member, or to a renter,guest, or vendor, and that if my Parking Pass is displayed in any vehicle other than a vehicle I’ve listed below, the vehicle may be towed at my expense, and that I will be subject to a $50.00 fine.

Electronic Signature:Enter your full name
Date:Today's Date

*Required Fields.       

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