WBA Membership

Please enter your information on the form below to apply for membership of the Wooden Boat Association

Username*

Password*

Retype Password *

First Name *

Last Name *

Address *

Town or suburb *

Zip *

Country *

State *

Email *

Mobile Phone

Phone - home

Phone - work

Interests

Small boats

Canoes/kayaks

Trailerable boats

Keel boats

Power boats

Model boats

Name of insured boat

Type of boat insured

Registration number of insured boat

Length (LOA)

Insurance Company

Policy Number

Policy expiry date

Is this an Individual or Family membership?

Individual

Family

If a family membership, please list family members here.

I agree to abide by the Rules of Association *

Yes

Payment Information

Price

$

Payment Method *

Credit Card (via Paypal)

Payment by Cheque or EFT

Credit Card Number*

Expiration Date*

/

Card (CVV) Code*

Card Holder Name*

I accept

WBA Membership

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Account Information

Payment Information

WBA Membership

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Not yet a member? Please complete the form below.

Account Information

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