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QUEENSTOWN HARBOR INDIVIDUAL MEMBER ENROLLMENT FORM 2016 PLEASE PRINT CLEARLY First Name: M.I.: Last Name: Address: City: State: Zip Daytime Phone: () — Evening Phone: () — E-mail address : D.O.B.

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Queenstown Harbor individual member refers to an individual who is a member of Queenstown Harbor, which is a specific entity or organization.

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The purpose of queenstown harbor individual member is to keep track of members, maintain membership records, and ensure compliance with rules and regulations of Queenstown Harbor.

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