FALL LINE SKI CLUB

MEMBERSHIP APPLICATION

You must be at least 21 years of age

This membership expires on April 30, 2009

New Application_______ Renewal_______ Change of Data______

If this is a Change of Data identify your application with a name and member number and then fill in just the items that have changed.

Last Name, First, MI ________________________________

Address________________________________________

City____________________ State______ Zip_________

E-Mail Address ________________________________

Sex: Male, Female

Date Of Birth __________________

Marital Status: Married, Not Married

Phone (Home) (___ ) ________________

Phone (Work) (___ ) ________________

Emergency Contact Phone (___ ) ____________________

Occupation __________________________

Do you wish NOT to receive a newsletter? This might be desirable where more than one member resides at the same location causing multiple copies to be mailed to the same location. If you pick this option be sure at least one member is scheduled to receive a newsletter. You can reactivate the newsletter at any time.________ Withhold newsletter

Skiing Experience: None, Beginner, Intermediate, Advanced

How did you learn about Fall Line Ski Club (new members only)? _____________________________________________________

1. Do you consent to release your phone number to other members upon request? Yes, No

2. Would you like to serve on a Committee or Board? Yes, No

3. Would you like to be a trip leader? Yes, No

4. Circle "Yes" if you wish to receive ONLY club related e-mails.                    Yes 
    Non-club e-mails are e-mails that may be of interest to members such as parties or get-togethers from other  members. They are not e-mails from outside sources. Your e-mail address is not given out to other members. Fall Line sends out the e-mails in their behalf. By circling "yes" above you will not receive these e-mails from other members.

RELEASE/COVENANT NOT TO SUE-READ CAREFULLY BEFORE SIGNING

Whereas Fall Line Ski Club is a non-profit corporation and existing under the laws of the state of New Jersey; Whereas the officers, directors, trip leaders, social coordinators and other members of the club work for no or nominal consideration; Whereas it is in the best interest of the club that these members, while acting in their official capacity, be provided with immunity from any claim or suit from other members of the club. Therefore, in consideration of membership in Fall Line Ski Club and other valuable consideration, the undersigned agrees to and does hereby for himself or herself and for his or her heirs, executors, administrators and assigns, release and forever discharge any officer, director, trip leader, social coordinator and any other member acting in an official capacity for the club of and from any and all claim or claims, all manner of action or actions, cause or causes of action, suits or demands which he or she now has or may hereafter have against the aforementioned members by reason of any damage, loss, injury or suffering to his or her property or to his or her person of any accident or injuries due to negligence or otherwise on the part of any officer, director, trip leader, social coordinator or any other member acting in an official capacity or for that matter, and any other member, whether acting in an official capacity or not; and furthermore, he or she for himself or herself and for her heirs, executors, administrators and assigns, agrees and covenants not to institute, bring, commence or prosecute any action, suit or proceeding, at law or in equity, against the aforementioned members on account of any claim , action, cause of action, suit of demand released, relieved and discharged herein.

Applicant: ____________________________ Date: _____________

Please forward by mail to:
Robyn Taddei
9109 Verree Rd.
Phila., Pa. 19115

Membership Fee:
$25 thru 9/13/07
$30 after 9/13/07 to 4/30/09

Your membership card will be ready for pickup at the membership table at any meeting unless you request it mailed to you although you do not need the card itself to participate in any event. Being a member is the only requirement. If you wish it mailed to you please enclose a SASE.