MEMBERSHIP APPLICATION & SURVEY – LPSC – A Four Season Sport and Social Club

Type of Membership

Single Membership, $35.00 annually
Married or Co-habitating Couple, $60.00 annually (Each person must submit their own, signed application)

If joint membership, provide name of partner below (They still need to fill out their own form)

Today's Date

Name

First

Last

Birth Month and Day

Address (Street, City, State, Zip Code)

Your Telephone Number

Email

I am 18 yrs or older

Yes
No

AGREEMENT: I have read the club's CONDUCT POLICY and TRIP AND EVENT POLICY and will abide by all rules

I Agree

Waiver: Los Padres Ski and Social Club is a year-round not-for-profit social and sports club providing a variety of activities for its members. Most of the activities are, to a varying degree, hazardous. By making this application for membership I voluntarily assume the risks involved. By assuming all risks involved, I agree not to hold Los Padres Ski Club, its Officers, and Board Members liable for any accident or injury resulting from my participation in a Club activity. After reading and understanding this Release of Liability, I voluntarily sign this release and hereby apply for membership in Los Padres Ski Club.

I agree

Please print your name here. By printing your name, you are formally submitting this form for approval by the club

Today's Date

Membership is not complete until dues are received. How do you plan to pay dues?

Payment through Zelle (Payee is LosPadresSkiClub@gmail.com)
Payment Through Venmo (Payee is @Los-Padres-Ski-Club)
Give Payment to Kent Adams, VP of Membership
Send a check to LPSC, P O Box 6112, Oxnard, CA 93031 (least preferred, too slow!)
Dues being paid by partner (Joint Membership only)
Already Paid! Please put date paid and how in comments section below.

yrs to Birth

Payment Comments

Membership Survey: Are you willing to assist the Club with any of these types of tasks/trips/events?

1. Finding speakers for general meetings
2. BBQing at general meetings
3. Cleaning up after general meetings
4. Planning and/or Leading hikes
5. Planning and/or leading bike rides
6. Suggesting and/or scoping out locations for TGIT happy hours
7. Finding/coordinating/leading neat events the club can attend or participate in
8. Planning/coordinating ski and other overnight trips
9. Recruiting new members

Survey Comments