Membership Application Form

BaltimoreCanoeClub.org

Mail this form to: BCKC ● PO Box 135, Savage, MD 20763

Membership dues are $20 per family/household per year and are for one calendar year (January 1 – December 31)

By joining the Club/renewing your membership you are agreeing to abide by the Club Policy on Outings and to the release set out below for yourself  and on behalf of all family/household members listed on this Application Form.

PLEASE PRINT LEGIBLY                   New Member:                   Renewing Member:       

Name:                                                                                     Date:  ___________________

Address:                                                                                 

City, State Zip:                                                                        

Email:                                                                                     

Phone:                                                                                   

Website Information:

New/Existing Username:                                                      

New User Password:                                                           

GBCC Dues:   $20.00   -     Please make checks payable to Baltimore Canoe and Kayak Club, Inc. 

TOTAL            $           

List Family/Household Members Included in this Membership Application

Print Name                                                                    Minor / Adult (Circle One)

                                                                                     ( A / M )

                                                                                    ( A / M )

                                                                                     ( A / M )

                                                                                    ( A / M )