Concerned Citizens of Captain’s Cove, LLC Membership Application*

Name(s):

Last_______________________ First________________________

Last_______________________ First________________________

Section(s)--Lot(s)

 ______________________________________________________

Please enter information for all lots owned

Mailing Address:

_______________________________________________________

_______________________________________________________

Email Address(s):

_______________________________________________________

                                  Please Print Clearly

Contact Phone #:

 ______________________________________________________

Mail $30 check payable to CCCC to:

CCCC

P.O. Box 53

Greenbackville, VA 23356

*Annual Membership dues include owner(s) of record/spouse and follow the calendar year from 1/1-12/31. 

Charter membership of one time fee of $312.50 is available; however, once you no longer own property in Captain's Cove, your membership terminates. 

Updated 3/3/2024