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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)

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:____________________________________________________

(Contact Bob Young for more information)