Bear Valley Ski Club Membership Form 2009-10

Date: ____________________

Family Name: ________________________________________

Male (husband) ______________________________________

Female (wife) ________________________________________

List Children under 21 years of age .......... Birthdays

______________________________ _____ / ____ /____

______________________________ _____ / ____ /____

______________________________ _____ / ____ /____

______________________________ _____ / ____ /____

Home Street Address: __________________________________________________

(If not located in mountains)

Home City & Zip: ____________________________________

Home Phone #: ______________________________________

Email Address: _____________________________________________

Mtn. Home Address: ____________________________________________________

(Include both PO Box & Street address)

Mtn. City & Zip: ______________________________________

Mtn. Phone #: ________________________________________

If a new member how did you hear about the Club?__________________________________________

If you would like to be listed on our “non-ski” activity list please add your name and activity(ies) on the back of this form and check here ______.

ANNUAL DUES: Family membership - $30: Single membership - $15. Make checks payable to Bear Valley Ski Club and send with the completed application form to:

BVSC MEMBERSHIP
c/o Fred and Patricia Evans
189 Arbuelo Way
Los Altos, CA 94022