Membership Registration Form

This form is for new member and renewal registration. Please provide the requested information in order to assure that your request is handled in a timely manner. Please fill-out and print this form for your records. Then select "Register" which will send the information to the Membership director. If paying by check send the form with your check to our P.O. Box listed below. If paying by credit card click on the credit card button near the bottom of this page. Memberships are annual and non-refundable once accepted.

First Name:
Last Name:
Street:
City:
State:
Zip Code:
First Telephone:
Second Phone:
Third Phone:
E-mail:
Birth Date:
Other Information:	Male Female Single Married
Name to appear on membership badge

I would like to participate in the following committees:

Ski	Racing	Membership	Tennis
Volleyball	Social	Ways & Means	Public Affairs
Computer	Golf	Directory

Ski Experience:

None	Beginner	Novice
Intermediate	Advanced	Expert
Interested in Racing


Please use this box for additional comments you wish to make:

Release of Liability

In consideration of the BSSC's acceptance of my membership and renewal thereof, and for other good and valuable consideration, I, on my behalf and the behalf of my legal representatives, including my spouse, if any, and insurers, do hereby waive, release and forever discharge the BSSC, its officers, directors, employees and agents including but not limited to activity leaders, of and from any and all claims, loss, cost, damage to property which I may sustain as a consequence of the negligence of any such entity or person in connection with or related to any activity arranged, organized, sponsored or managed by BSSC, including transportation to and from such activity.

I understand that the BSSC will not accept my membership unless I sign or check 'Accept' of this Release, which I have read and to which I voluntarily agree.

Signature __________________________ Date __________

Membership Cost

Cost to join: $65.00 ($50 annual membership fee plus $15 new member fee)

Please supply the following payment information:

Check Number
Amount Paid
Credit Card (check here)