Well Requests

2018 Well Requests

To ensure a spot for the 2018 season, please fill out the below well request form. Alternatively, fill out a physical request form and leave in the manilla envelope located at the club, or submit to Brian Casey.


LaSalle Mariner's Yacht Club Dock Request Form

To guarantee a spot, this form must be filled out and submitted by March 15 electronically, or
physically submitted to the manilla envelope marked "Dock Request Forms" at the LMYC clubhouse.

Owner Name (required)

Phone Number: (required)

Email: (required)

Vessel Name: (required)

Make: (required)

Length: (required)

Beam: (required)

Draft: (required)

Insurance Provider: (required)

Policy Number: (required)

Proof of Insurance: (required)
Please provide a scanned copy or picture of your policy.

Are you leaving a dinghy on the property?: (required)

Dinghy Serial Number:

Dinghy Identification (Description):

Boat tenders (Zodiac, Achiles, etc.) are your responsibility and should not be kept at the dinghy
dock. They should be stored on, secured to your boat, or stowed away to prevent theft. L.M.Y.C. shall not be responsible for your tender, should it go missing.

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