For information Call (978) 372-0044  or email to membership@seacoastskiclub.org

Type: (circle one)   New      Renewal      Change of Membership Information 

 Individual Membership – $30   Family Membership – $45  Temp membership (one trip) _ $20

Mailing Address ______________________________________________________________________________

City ______________________ State ___ Zip _________ E-mail _________________________

Home # ___________________ Work # _____________________ Omit number from the directory? __ Y__ N

Fax #_______________ OK to fax (Y/N) Ages: _______/_______ Occupations: _________________________

e-mail address                                                                              

Learned of SSC from: ________________________________________________ (for informational purposes only)

Areas of Interest: __ Skiing __ XC Skiing __ Snowboarding __ Kayaking __ Canoeing __ Cycling

(check all that apply ) __ Hiking __ Scuba Diving __ Other ____________________________________________

I would be interested in __ Leading Trips __ Special Projects __ Other _________ Are you available mid-week? __

I recognize that all Club Activities can be potentially hazardous, and I will not hold the Seacoast Ski Club or any of its members responsible for any injury or damage encountered while participating in, or traveling to and from, any Club function.