Associate Membership Application / Waiver

JUNE 2016                                                      WWW.JOLIETSKICLUB.ORG                                                       Vol 47 No.1  

 

Joliet Ski Club
Associate Membership Application and Waiver

P.O.Box 2542, Joliet IL 60434-2542

$10 per adult for an overnight/day trip.        $20 per adult for an weekend trip.
Fee must be paid separately when registering for the applicable trip.

Name ___________________________________________________________________Date of Birth _____-_____-_____
Address _______________________________________________________________________________________________
City __________________________________________________State __________________Zip Code _______________
E-Mail Address ________________________________________________________________________________________

 

Home Phone __________________________________ Work Phone _____________________________________________
(Note: Your address and phone numbers will be used only for club records and correspondence.)

 

                  This trip associate membership applies to:  __________________________________________________________________________

                  Associate Membership fee paid  (Amount)  __________________________________________ Date ________-________-_________

 

Children under 21 ( natural, adopted, or assigned guardianship)  If they will be participating on the same trip.

 

  • (1)______________________________________________________________________ Date of birth___________-_______-_______
  • (2)_____________________________________________________________________ Date of birth___________-_______-_______ 
  • (3)______________________________________________________________________ Date of birth___________-_______-_______
  • (4)______________________________________________________________________ Date of birth___________-_______-_______
  • (5)______________________________________________________________________ Date of birth___________-_______-_______

 

I apply for membership in the Joliet Ski Club and pledge that, if accepted, I will abide by the Constitution, By-Laws, and Ski Club policies to conduct myself in a socially accepted manner and to assist the officers and members in accomplishing the objectives stated in Article II of the Joliet Ski Club Constitution to the best of my ability.
Also, I hereby agree to release and waive any rights, damages or recovery for my loss, including but not limited to, any bodily injury, death, loss of income or disability which may arise out of an activity, accident or loss of equipment which I sustain as a result of any club activity.
Written Joliet Ski Club policies are posted and available from any board member. The constitution and by-laws are available from the club president.

_________________________________________________________________________________ Date ___________-_____-_____
Applicant's Signature 

_________________________________________________________________________________ Date ___________-_____-_____
Trip Leader's Signature 

________________________________________________________________________________ Date ___________-_____-_____                                                        Membership Director's Signature

 

 

Form adopted 05/13