Print & Mail to:
Charlotte Breezers Ski and Sports Club, Inc.
Application for Membership
5307 Crisfield Road
Charlotte, NC 28269

Name: ________________________________________ E-mail______________________

Address: __________________________________________________________________

City/State/Zip:______________________________________________________________

Home Phone: _____________________ Work Phone:_______________________________

INTEREST/HOBBIES:________________________________________________________

SKIING ABILITY: (Check one)
O Beginner
O Intermediate
O Advanced
TYPE OF MEMBERSHIP: (Check one)
O Individual ($35)
O Youth (Under 18 - $15) ____(Youth's Age)
O Family ($65)

Payment must accompany application (checks and money orders only). Payment covers period thru October 1st.

I agree to abide by all the rules and regulations prescribed by the Charlotte Breezers Ski and Sports Club, Inc. I also acknowledge that the Charlotte Breezers Ski and Sports Club, Inc. has the right to revoke my membership for any infraction of the rules and regulations.

Signature___________________________________________Date______________________

Guardian___________________________________________Date______________________

RELEASE AND ASSUMPTION OF RISK
I fully realize that Charlotte Breezers Ski and Sports Club, Inc. activities involve a risk of personal injury and property damage, and I hereby agree to assume all risk of any injury, damage or loss of my person or property. I hereby for myself, my heirs, executors and administrators, waive and release any claims or rights against Charlotte Breezers Ski and Sports Club, Inc. and all injury, damage or loss to my person or property incurred during travel or participation in any of these activities.

If my membership application is approved, I agree to abide by the Bylaws and Policies of the Charlotte Breezers Ski and Sports Club, Inc.

Signature___________________________________________Date______________________

Guardian___________________________________________Date______________________
ALL ADULTS MEMBERS MUST SIGN
If under 18 years of age, signature of parent or guardian is required.