Pickwick Cruising Club


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Your Name:
Spouse's Name:
Children's Names:
Street Address:
City:
State:
Zip Code:
Home Phone:
Work Phone:
Cell Phone:
Pager:
Emergency Contact:
Emergency Phone:
Boat Name:
Type of Boat:
Mooring Port:
Slip #:
E-Mail Address:



Also if you have pictures of your boat, children, etc. you would like used for this Web Site under your name, please send us an email and attach the photographs. If you do not have a scanner or a "gif", then you can mail us the photos you wish us to use. After they have been scanned in and placed on the Web Site we will make sure they are returned to you.




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