AOTC Membership Application

Please fill out the form--starred items are required. Note: for change of address use this form: Change Address

 


 - $35 (Single or parent w/ children)
- $50 (Married couples incl. children)

Please provide the following member information and any information that may have changed:

Fill Column For All Membership Types

For Family Memberships Only: Spouse
First Name* Spouse First Name
Middle Initial Spouse M.I.
Last Name*
Gender*   
Marital Status
# Children Under 18
Street Address*  
Address (cont.)
City*  
State/Province*  
Zip/Postal Code*

Spouse
Age Group Age Group
Home Phone* --
E-mail*   E-mail
Work Phone --

Work Phone

 --

Include me in Club Directory (click "No" to be excluded): Yes  No

By checking the following box you are maintaining that: "I/We intending to be legally bound members of the Arizona Outdoors and Travel Club™ (AOTC); do hereby, for myself, my family, and my heirs release all rights and claims for personal injuries or damages I/we incur while participating in AOTC-sponsored activities.

I/We agree to the waiver liability stipulation above: Agree

Copyright © 1999 Arizona Outdoor Travel Club. All rights reserved.
Revised: December 22, 2002