Lake Minear Beach Fishing Program Registration

Fishing Program Registration
Dear Member, Thank you for joining Lake Minear Beach. In order for us to send you your gate key I will need further information for extended fishing. Could you please fill out the information below and mail it back to me as soon as possible.
Name:*
Email Address:*
If you plan to fish from shore only, please check here
If you are going to use a boat, please fill out the information below and I will need a copy of insurance showing liability coverage. This applies to any type of watercraft. Most small boats such as row boats or canoes are covered under your homeowner’s policy. You can have your insurance company fax over a certificate to 847-680-8897 or you can mail one to me at: P.O. Box 574 Libertyville, Il 60048.
Boat registration number:*		License number:*
Vehicles make & color:*		Horsepower of motor: *
Vehicle license number:*		Type of boat:*
* Required Information
Thank you, Mary Conn Director of Membership
Before submitting this form be sure you have already purchased Extended Fishing.

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