Elmhurst Ski Club - Membership Profile

2007-2008

Dues Paid: $20____________

Name: ______________________________________________________________________

Address: ______________________________________________________________________

City: _____________________________State: _________Zip: ___________________________

Home Phone: ___________________________Cell Phone: __________________________________

Business Phone: ____________________Email Address__________________________________

Never Novice Intermediate Expert

Ski Ability: 0 1 2 3 4 5 6 7 8 9

(Circle One)

I am interested in helping the Elmhurst Ski Club for the following;

___________ Membership

___________ Special Events

___________ Newsletter

__________ Trips

__________ Publicity

__________ Other

How did you hear about the Elmhurst Ski Club? ______________________________________________________________________

Agreement

I agree to maintain the standards and reputation of the Elmhurst Ski Club and to follow the directions of its leaders. I hereby release the Elmhurst Ski Club and its agents and officers of any and all responsibilities or liability of any nature whatsoever for any loss of property or personal injury occurring on any trip under its management or with any activity or function related to the Elmhurst Ski Club. I certify that I have read and understood this agreement. _____ initial here.

Signed: ___________________________________________

Date_________________

Optional Information:

Birthday ____________________ ______ Anniversary _________ _________ _________

Month Day Month Day Year