Registration Form

Please complete one per family member and mail to:
WCNSC
119 Dunhaven Dr., Box 8008
RR#2 Dunrobin, K0A 1T0
         
    Surname:_______________________________  First Name: ____________________________

    Address:_________________________________________________________________________
         
            _________________________________________________________________________
         
Postal Code:________________________   |          Gender: ___Male ___Female   
                                       | 
     E-mail:________________________   |        Category: ___Senior ___Adult ___Child 
                                       |   
  Telephone:________________________   |  Skier Qualifications: _____________________ 
         
                 
Registration Fees Enclosed:    $ _______________  Make Cheque Payable to: WCNSC
                 
A Parking Pass will be mailed out apon receipt of this form. If you wish to 
receive one sooner,  please call Bryan @832-0627 or, e-mail, to arrange a pick-up.
                 
    WAIVER: (PARENTS TO SIGN FOR CHILDREN UNDER 18)
         
I HEREBY AGREE to abide by the rules and regulations of Cross Country Canada (CCC),
the National Capital Division (NCD)  and to participate in the events, activities and
programs sanctioned by CCC and the NCD in accordance with the  Associations Rules,
Regulations and By-Laws. IN CONSIDERATION OF CCC, the NCD and the WEST CARLETON NORDIC
SKI  CLUB's acceptance of me as a registered member of the Association, and my being
permitted to take part in the Association's events, activities, and programs, I hereby,
for myself, my heirs, executors, and administrators and assigns,  forever release,
discharge, hold harmless CCC, the NCD, the WEST CARLETON NORDIC SKI CLUB, its directors,
officers, employees, representatives or agents.
        
         
Date: _________________________ Signature: ________________________________________