Name(s): _______________________________________________

Street/PO Address: _______________________________________

City/St/Zip: _____________________________________________

Telephone - Home: ____________ Work: ____________

Emergency Contact Name: ____________________________________ Phone Number: _________________

In an attempt to keep our costs, and therefore our dues, as low as possible, the club offers an online alternative to the traditional paper newsletter. If you will provide your email address, you'll receive the montly newsletter in both formats, and can then tell us if you'd prefer to receive one form rather than the other, or to receive both. The club will not provide your mailing address, phone numbers or email address to any organization or business, without your permission.

E-mail - ______________________________________

Check One:

(___) New Individual Adult Membershp - $25

(___) Renewal Individual Adult Membershp - $15

(___) New Family Membershp - $35

(___) Renewal Family Membershp - $25

Make checks out to the Fredericksburg Ski Club and mail to:

Fredericksburg Ski Club
PO Box 3411
Fredericksburg, VA 22402-3411


FSC Disclaimer of Liability: The Fredericksburg Ski Club (FSC) is a non-profit organization that arranges trips and activities for the enjoyment of its members. FSC and its officers and designees expressly disclaim responsibility and/or liability of any nature whatsoever for loss, damage or injury occurring during any trip or activity that FSC arranges, organizes, sponsors or manages. I/We have read this disclaimer, understand it, and agree to abide by its provisions


Signature: ____________________________________  Date: ___________ Date of Birth _______________

Spouse Signature: ______________________________ Date: ___________ Date of Birth _______________