Membership Form

MAIL FORM AND PAYMENT: Please print the application below (using your web browser’s print function). Complete it, sign, and mail the application with a check for the first year’s dues of $20.00 to: CCC Membership Chairman, PO Box 12932, Raleigh, NC 27605 .

Please note that there’s a signficant delay in processing your membership by check. The PO Box is at best checked weekly, and then the check has to process through. Plan accordingly!

Last Name*
First Name* and names of persons residing in same residence
Address*
City, State Zip*
Home Phone
Work Phone
Primary Email Address*
Secondary Email Address
I do NOT want my name, address and phone number released to conservation and river groups for special mailings and fund raisers.
All participants in Carolina Canoe Club trips do so as common adventurers. The club or its individual members may coordinate paddling trips but no one is considered leader of a trip. All participants take the responsibility for making their own decisions including, but not limited to, whether to participate on any particular water body or section, what equipment they use, the routes they may choose to paddle, whether their skill levels and abilities are appropriate for the activity or whether climate and water conditions are appropriate for their participation.

In applying for membership to the Carolina Canoe Club (CCC), I acknowledge that paddling, like many sports, has inherent dangers which can be minimized through education and experience, but cannot be totally eliminated I hereby, for myself, my heirs, executers, and administrators waive any and all rights and claims for damage I may have against the CCC, its officers and representatives for injuries suffered by me in CCC activities.
Membership Options (Dues are paid annually, based on the month in which you joined. Your renewal date is the beginning of that month)
 $20 per year

Signature_________________________________________ Date________________________