PTCC MEMBERSHIP RENEWAL OR NEW MEMBER APPLICATION FORM

For paddle season ending Oct 31 2010 Renewal [ ] New Membership [ ]

I wish to apply for or renew my membership in Paddle Trails Canoe Club. New membership payments made in July August and September apply to the following year's dues.	Interests		Volunteer
	Extended trips	[ ]	Membership	[ ]
	Camping	[ ]	Conservation	[ ]
	Whitewater	[ ]	Safety	[ ]
	Flatwater	[ ]	Training	[ ]
Membership Fees: $25 per household	Training	[ ]	Social	[ ]
	Boat Building	[ ]	CaNews	[ ]
	Racing	[ ]	Trip Schedule	[ ]
			Nominations	[ ]
			Web Page	[ ]
Safety Creed In the interest of members own safety and that of other members, participants agree to abide by the rules of this club. If less than 18 years of age participation in club activities will be with parents or guardians consent and their full assumption of responsibility in case of accident. By applying for new or renewal of membership, participants affirm their endorsement of this safety creed. Assumption of Liability Members agree that their participation in paddlesports involves certain risk to life and property. They agree to use their own judgment for determining participation in Paddle Trails activities and to assume all responsibility for themselves. The Paddle Trails Canoe Club, its officers and trip coordinators are absolved of all liability for any loss of life or property, physical injury, or property damage. List Household Participants Name_________________________________________ Name_________________________________________ Name_________________________________________ Minors Name____________________________ Date of Birth ____ Name____________________________ Date of Birth ____ Name____________________________ Date of Birth ____ Name____________________________ Date of Birth ____ Name____________________________ Date of Birth ____ Date ___________ Mailing Address___________________________________ City: _____________________State: ___Zip: _________ E-Mail ____________________________________ Phone # _______________ Please Mail this completed form, & Dues to Paddle Trails Canoe Club P.O. Box 24932 Seattle WA 98124

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