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Lapsed members click here WAIVER/PAY IF LAPSED MEMBERSHIP proceeding directly to Waiver/Pay and dont complete a new application.

To apply for membership:
Please fill in the form and click on 'Apply' when finished.
Important: Couples are recorded as one application.

This Application is for Individual Couple

First Name:
Last Name:
Spouse or Partner's First Name:
Spouse or Partner's Last Name:
Street address:
City:
State:
Zip Code:
Main Phone: Format 000/000-0000. Land line or cell.
Emergency Contact:

Applicant

Spouse/Partner

Mobile Phone:
Format 000/000-0000 please
E-mail:
Confirm E-mail:
Born Year-Month-Day:
Occupation
now or before retirement:
Retired : please check this box

Interest in Volunteering:

Elected Board/Officer:

Trip Leadership & Assist:
trip/campout leader, co-leader, or assistant
Club Support & Coordination:
Membership Coordinator, Activities Coordinator,
Trip Treasurer, Web Support etc.

Activities:

DH Ski
XC Ski
Snowshoe
Hike
Camp
Canoe or Kayak

Interests:

Golf
Tennis
Bike
Bridge
Other:

How did you hear of us? Did a member recommend us?

Name of any Referral:

To protect our form from 'Robots', please answer our (anti-robot) question. What is the name of the mountain 50 miles East of Portland?
Mt.