NEW MEMBER APPLICATION

New Member Information *Required

Type *

FIRST NAME *

LAST NAME *

E-MAIL #1 *

E-MAIL #2

Primary Address *

ADDRESS

City

State

Zip

Home Phone

Cell phone

Local Address

ADDRESS

City

State

Zip

Home Phone

Family Member Information *

Spouse / Partner FIRST NAME

Spouse / Partner LAST NAME

CHILD 1 NAME

CHILD 1 BIRTHDAY

CHILD 2 NAME


CHILD 3 NAME

CHILD 3 BIRTHDAY

CHILD 4 NAME

CHILD 4 BIRTHDAY

CHILD 5 NAME

CHILD 5 BIRTHDAY

Please check all club activities and features that you would be interested in as member(s):

IF OTHER:

How did you hear about Killington Ski Club?

Please list an active member that will be used as a reference, Name & Contact Information:

VALIDATION