| Names of Members | |||
|
Surname |
First Name | Sex (M/F) | Birth Date (YY/MM/DD) |
| Address and telephone number | |
| Street/Box No: | |
| Town/City: | |
| Postal Code: | Home Telephone: |
| Email Address: | |
| Membership Category (Please tick) | Fee | |
| Adult (21 years and over) | $30 | |
| Junior (20 years & under) | $15 | |
| Family (All people living in the same household with no more than 2 people over 25 years old) | $60 | |
| Associate (for groups only; leader must pay membership fee) | $40 | |
| New Member (new members pay 50% of above fees for their first year) | ||
| Former Member | ||
Please make cheque payable to:
Manitoba Orienteering Association
Mail membership application, signed waiver and cheque to:
Manitoba Orienteering Association
200 Main Street
Winnipeg, Manitoba
R3C 4M2
Waiver:
In consideration of the Manitoba Orienteering Association accepting this application for membership, I, the applicant, on behalf of myself, members of my family, or all members of the group represented here, do hereby waive all responsibility from the Manitoba Orienteering Association and/or its associated clubs and its agents for any loss of property or personal injury that may occur during participation in an event sanctioned by the Manitoba Orienteering Association.
I acknowledge that Orienteering is a sport with risks (both known and unknown) inherent in it, and in signing this application it is my intention to accept those risks, and all consequences thereof, for myself alone. The terms of this release are severable from one another, and in the invalidity of any one or more clauses of this release, shall not affect the validity of the other clauses. I acknowledge that I have read this release in its entirety, that I understand and agree to be bound by its terms, and that I am signing it voluntarily and without duress or undue influence from anyone.
____________________________
____________________________
Signature of
Applicant
Signature of Parent/Guardian
If you know of anyone who might be interested in learning about orienteering please provide their names and addresses below and we will send some information to them. This is one of the best ways to increase orienteering's membership!
| Name | Street | Town/City | Postal Code |