Membership Form

CARSON FLY FISHING CLUB - P.O. Box 3163 Carson City, NV 89702

MEMBERSHIP FORM - Year____________

Name:________________________________________________________________________

Address:______________________________________________________________________

City:_______________________________________ State:____________ Zip:_____________

Phone:_______________________ E-Mail Address:___________________________________

Your level of expertise? Novice:_________ Intermediate:_________ Expert:__________

What are your interests in fly fishing?_______________________________________________

______________________________________________________________________________

Topics you would like the club to address?____________________________________________
______________________________________________________________________________

Note: Dues run on a calendar year (Jan.-Dec.)
New membership dues received before November 15th are considered dues paid for the current calendar year and membership will need to be renewed at the beginning of the new year.

Please print this form, write your check for $30, and mail it to NAME and ADDRESS above. Thank you.

WAIVER OF LIABILITY, ASSUMPTION OF RISK, and Emergency Contact Information

In consideration of being allowed to participate in CFFC events and activities, I, the undersigned, acknowledge, appreciate and agree that:
1. Knowingly and freely assume all such risks both known and unknown, and assume full responsibility for my participation; and I willingly agree
to comply with the stated instructions and policies and customary terms and conditions for participation.
2. I hereby release to the Carson Fly Fishing Club and its officers, directors and sponsors harmless with respect to any and all injury, disability,
death, or loss or damage to person or property, to the fullest extent permitted by law.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS AND I SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

SIGNATURE__________________________________________________ DATE:____________________________

Emergency Contact Information

NAME_______________________________________________________

RELATIONSHIP_______________________________________________