2011-2012 Nooksack Nordic Ski Club Membership Application/Sno Park Order Form

Use this semi-interactive form to purchase Sno Park permits, join the club, or to renew your membership.

You can type some things in the form, and use a drop down menu)

Name:

Address:

City: State: Zip:

Phone 1: Cell Phone Home Phone Work Phone Phone 2: Cell Phone Home Phone Work Phone

E-mail 1:

Select Club Membership level from list: $15 Student $15 Student $30 Individual $45 Household/Family

Season Sno Park Permit: $40.00 Yes No Vehicle License #:

TOTAL: $

Please read this agreement carefully before signing and dating

In signing and submitting this form, I recognize that cross-country skiing involves strenuous activities, is potentially hazardous, and involves inherent risk. I knowingly and voluntarily assume all responsibility and risk for my actions and my family’s actions while cross-country skiing, during travel related to Nooksack Nordic Ski Club (NNSC) activities, and during use of facilities and equipment. This includes, but is not limited to falls, collisions, effects of weather, conditions of equipment and trails and other areas while skiing or participating in NNSC activities. I hereby for myself, my heirs, administrators, or anyone else who may bring claims on my or my family members’ behalf, covenant not to sue, release and discharge the NNSC, its Board and Committee members, and all related organizations or individuals, from any and all claims of liability for death, personal injury, or property damage arising from my or my family members’ participation in NNSC activities.

Name (Print please): ______________________________________________________________________________

Signature: ______________________________________________________________________________________

Other Family Member(s): __________________________________________________________________________

Other Signatures: _________________________________________________________________________________

Date: __________________________________________________________________________________________

Please distribute my address and contact numbers to the membership. We omit street address from the distribution list, showing only city, phone and email address(es), (Please note, if you decline to be listed, then you won’t get the list, either) Yes No

I want to receive the newsletter by: Select method U.S. Mail Email Web