AOTC Membership Application
Please fill out the form--starred * items are required. Note: for change of address use this form: Change Address
Fill Column For All Membership Types |
For Family Memberships Only: Spouse |
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| 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* | |||
| 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