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CHESAPEAKEYACHTCLUBTRANSIENTRESERVATIONFORMANDAGREEMENT

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ARRIVALDATE: DEPARTUREDATE:

VESSELINFORMATIAON:

VESSELNAME:

LENGTHBEAM:DRAFTMAKE:

POWER:30AMP

50AMP

# OFPLUGS

INSURANCECOMPANY:POLICY#:

EXPIRATIONDATE:LIABILITYInsurance:$(MINIMUM$500,000)

RATES:

$2 per foot, per night, plus $10 for one 30 amp service or $15 for 2-30 amp or 1-50 amp. Non-Refundable 1st Night Slip Fee by Check Payable to “Lucia Casale.” Lucia will write one check to CYC after all the reservations are collected. You will receive a temporary CYC club number for all other activities i.e. bar, meals, casino night, to use once you have arrived. Need Help: call Lucia (202) 378-8750 (mobile).

OWNERINFORMATION:

OWNER’S NAME:

PHONE:CELL:

EMAIL:

MAILINGADDRESS:

CLUBAFFILIATION:

MEMBEROFCBYCA CLUB:(Y/N)

MEMBEROFCLUBWITHRECIPROCALAGREEMENT(Y/N)

CLUBNAME:

TheSlip and theproperty and premises of Chesapeake YachtClub,Inc.(“Club”) are to beused at thesole risk ofVisitingYachtsman,his agents,and hisguests (“Visitor”).Visitor hereby assumes any and allsuch risk.TheClub assumes no responsibilityfor,and shallnot be liable for thecare,protection,and/or securityof theVisitor andtheBoat.This Agreementdoes not create a contract ofbailment.Visitor herebyreleases Club fromanyand all liability for loss,death,damage orinjury (collectively “injury”) to anyperson or propertyarisingoutof orin connection with thecondition oruseof theBoat ortheconditionor useof theClub or itsservices,whether such Injuryis caused byor through theactsor omissionsof theClub or by anyother cause whatsoever,includingbutnot limitedto,fire,theft,weather condition,etc.,exceptfor Injuries dueto Club’s gross negligence or willful misconduct.Visitorshall indemnify and hold harmless the Club fromanyclaims,suits,actions,damages,liability or expense (includingattorney’s fees) in connection with any Injury(unless dueto thewillfulmisconduct or gross negligence of Club) or arisingfromVisitor’s breach oftheAgreement.Club is not to be considered as an insurer of Visitor’s propertyand Visitorshall secure,at a minimum,theinsurancerequired bythis Agreement.Under no circumstances shall the Club beliable forindirect,consequential,specialor exemplary damages,either in contract ortort(includingstrictliability andnegligence) with respect to Visitor’s use of theClub.Visitor and Visitor’sinsurers agree to waive anyrightto petition for exonerationfromor limitation ofliability under the laws of United States intheeventtheBoatis involved in any casualty resultingin personalinjury,deathor propertydamagewhiledockedat theClub orin connectionwith this Agreement.

Visitor acknowledges thatthey have read and fullyunderstandthis Agreementand theVisitor’s GuidetoClub Facilities.

Signed

Date

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