Application for Membership in the Denver Group
of
The Colorado Mountain Club
(For family memberships, we need a
separate application and liability waiver for each family member. Feel free to
copy this application, or call us for additional applications.)
I hereby apply for membership in
The Colorado Mountain Club. I agree to be solely responsible for my own safety
and to take every precaution to provide for my own safety and well-being while
participating in activities of The Colorado Mountain Club.
Name (Last, First, Initial)
|
The
Colorado Mountain Club wants to serve and reflect a diverse society. You help
achieve this objective with your voluntary response to these items. Thank
you.
Ethnicity:
| African
American |
|
Latino |
|
| Asian
American |
|
Caucasian |
|
| Native
American |
|
Other: |
|
| Gender: |
Male
|
|
Female
|
|
| Date of
Birth |
Home
Phone |
|
| Occupation |
Work
Phone |
|
Workplace (home or name of
business)
|
|
| FAX, if
any |
E-mail, if
any |
|
METHOD OF
PAYMENT
If Family
membership, name of family member to be billed:
|
Check #
|
Visa |
|
Master Card |
|
|
| Card Number |
|
Exp. Date |
|
| Signature |
|
Date |
|
Mailing Address
|
City, State, ZIP
|
Home Phone
|
Work Phone
|
DUES & OTHER
OPTIONS
| Dues: |
|
| |
Includes subscriptions to the Denver
Group Monthly Newsletter Mile High Mountaineer and the bi-monthly
CMC publication Trail & Timberline magazine. Annual memberships
come up for renewal one year from the date of initial membership.
Lifetime memberships are equal to 30 years' individual dues. 40 year
members of the CMC no longer pay dues. Spouses of Life or 40-year
members pay only $10 per year. Reduced fees apply to all renewals.
$76 / regular first year membership $51 / regular renewal $1,555 /
life member $101 / first year family, one address $76 / family renewal
|
$
|
| |
Voluntary Conservation Contribution: help protect
the Southern Rockies $5-20 suggested |
$
|
| |
Voluntary Education Contribution: Youth and Adult
educational programs $5-20 suggested |
$
|
| Optional newsletter: |
|
| |
Thin Air (newsletter of the
High Altitude Mountaineering Section) @ $7/year |
$
|
| |
Switchback (newsletter of
the Trailblazers Section) @ $15/year |
$
|
| |
|
|
| Total |
$
|
|
Please remember to sign the
release of liability and send it in with your
application.