Membership Application / Renewal Form

Oregon Nordic Club – Willamette (Salem) Chapter

Membership Application / Renewal Form

Annual Individual or Family Membership fee is $20.00. Please make checks payable to Oregon Nordic Club Mail to: Oregon Nordic Club – Willamette Chapter P.O. Box 181 Salem, OR 97308

Name(s): ______________________________________________________________________________________________

Mailing Address: ______________________________________________________________________________________________

City/State/Zip: ______________________________________________________________________________________________

Phone: ____________________________________ (optional)

E-mail address: ______________________________(optional)

Do you prefer receiving your newsletter by e-mail? ____________________

You will enjoy faster delivery, colors other than black and white, and save the club mailing costs.

I hereby release the Oregon Nordic Club (ONC) from any liability for any injury to myself or my family which may occur while participating in any club activity. I realize that there are risks in the participation of this outdoor sport, and that some risks are unforeseeable. I freely give this release with full knowledge that this is a hazardous activity.

Signature: ______________________________________________

Date:___________________________________________

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