Grant MacEwan Mountain Club Membership Application Form

Please note: all membership applications and renewals must be accompanied by a signed copy of the club Waiver Form.

Mail this form with a signed copy of the waiver and payment to:

The Grant MacEwan Mountain Club, P.O. Box 934, Edmonton, Alberta, T5J 2L8

PLEASE PRINT

Application Date: _________________ . Individual ($35) or Household ($50)

Name(s):_________________________________________________________________

_________________________________________________________________________

Address:__________________________________________________________________

____________________________________________ Postal Code:__________________

Phone Numbers: Home:______________________Alternate:_______________________

Email (for Newsletter and other GGMC notifications):_______________________________

Check if you need to have a paper version of the Newsletter sent to you via Canada Post

Please check off those activities which interest you:

Hiking Cross-country Skiing Ice Climbing
Backpacking Backcountry Skiing General Mountaineering
Extended Backpacking Extended Ski Touring Glacier Travel
Rock Climbing Telemark Skiing Family Trips
Mountain Biking Snowshoeing Other (specify): _______________

Have you taken any of the following safety or outdoor skills courses? (please specify the instructor’s name, and when and where you took the course)

COURSE INSTRUCTOR & WHEN / WHERE TAKEN
Level 1 Avalanche Safety  
Level 2 Avalanche Safety  
Basic First Aid  
Wilderness First Aid  
Basic Rock Climbing  
Basic Mountaineering (Snow and Ice)  
Basic Ice Climbing  
Other:  

How did you find out about the Grant MacEwan Mountain Club? _______________________

The Grant MacEwan Mountain Club publishes a membership directory every July, which is made available to current members only. If you do NOT want to be listed in this directory, check here: I do not want my name listed in the annual membership directory

I HAVE READ THE GENERAL MEMBERSHIP AGREEMENT, I UNDERSTAND IT AND I ACCEPT ITS TERMS

Name: _________________ Signature: ___________________ Date: ______________

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