DOCK NUMBER: ___________________

OWNER / CAPTAIN: ________________________________________

ADDRESS: _______ _______________________________

________________________________________

TELEPHONE: ________________________________________

BOAT INFORMATION:

MC NUMBERS : _______________CELL PHONE # : ________________

MAKE / MODEL __________________________

DESCRIPTION: ____________________________________

ARRIVAL DATE: _____________________

TOTAL # OF DAYS: ____________

RATE : _____________

TOTAL AMOUNT DUE: __ __ ______(make checks payable to American Real Estate & Leasing Group LLC)

(cash or check only)

I ACKNOWLEDGE RECEIPT OF A COPY OF THE CLUB RULES OF WHEELER LANDING YACHT HARBOR AND AGREE TO ABIDE BY THEM.

_________________________________ __________________________________

(SIGNATURE) (DATE)

Please return completed form and payment to:

Attn: Bob Jennings

American Real Estate & Leasing Group LLC

1006 Marquette

Bay City, Michigan 48706

(989) 671-3700