Membership Application
|
Name |
Date |
||
|
Address |
City |
|
Zip |
|
Day Phone |
Evening Phone |
||
|
Signature |
Email (please print clearly) |
||
INTERESTS: Check all that apply. Your interests will
be included in the Membership Directory so that you may contact or be contacted
by others with similar interests.
|
Archery |
|
Kayaking/Canoeing |
|
Community Service |
|
|
Backpacking
|
|
Letterboxing/Geocaching |
|
Mother
& Child Outings |
|
|
Bicycling
|
|
Outdoor
Photography |
|
Couples Outings |
|
|
Bird
Watching |
|
Plant
Identification |
|
Have
an RV |
|
|
Camping
|
|
Map
and Compass Skills |
|
Retired/Available
Weekdays |
|
|
Cave
Exploring |
|
Rock
Climbing/Bouldering |
|
Other
(write in): |
|
|
Fishing/Flyfishing |
|
Windsurfing |
|
|
|
|
Hiking |
|
Wilderness
Survival |
|
|
|
|
Horseback
Riding |
|
Tubing |
|
|
|
___ Yes, you may publish my name and information in the club directory.
___ Yes, please add me to the yahoo e-group.
(Confirmation
will be mailed to you a soon as your membership application is approved)
___ I am interested in leading a TOWN outing. Location:________________________________
___ I am interested in being a speaker at a TOWN meeting. Topic: ________________________
___ I know someone who would be interested in being a speaker. _________________________
How did you hear about TOWN Austin?____________________________________________
What topics would you be interested in at future TOWN meetings/events? ______________________________________________________________________________
Membership dues of $20 are payable Feb. 1. If joining after Aug. 1, dues are $10.
Make your check payable to TOWN Austin and send your completed form to:
TOWN-
For
more information about TOWN-Austin and other chapters across
Disclaimer : By signing
this form, I am hereby releasing the TOWN Austin, it’s officers, members,
representatives, organizers, and sponsors from liability for injury to myself
or damage to my property as a result of participating in TOWN activities. I
assume all of the risk and accept personal responsibility for any damages,
personal injury, permanent disability, or death.