Application For Family
Membership In The
North Shore Erie Amateur Astronomers
(one way to print this form is just press CTRL + P together)
Date: ___________________
Names: __________________________________________________
___________________________________________________________
Address: _________________________________________________
____________________________________________________________
Phone: ________________________Email:
_________________________
Payment of $ 25.00 payable to North Shore Erie
Amateur Astronomers covers
a period of one year from the date given above.
Please mail this application
form and cheque to club treasurer Bernd Mueller, Box 128, Vittoria, ON, N0E 1W0 or better still bring them to our next meeting.
I/we hereby apply for
membership in the North Shore Erie Amateur Astronomers for the period stated
above. I acknowledge and agree that there are certain risks associated with Club
activities such as attendance at observation nights, field trips and other Club
sponsored events.
I therefore shall release
and forever discharge North Shore Erie Amateur Astronomers, all of its members,
past and present, all agents assisting the Club from any liability for injury or
loss arising from my presence at the Club’s events.
I consent that my phone
number and email address, if given above, may only be revealed to other club
members.
Signed:
______________________________________________________