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MEMBERSHIP APPLICATION: print page, fill out and mail to address below.
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2008 Membership Application - N. C. Fossil Club Name (s)
__________________________________________________________________________________________________ Address
__________________________________________________________________________________________________ City, State, ZIP
_____________________________________________________________________________________________
E-Mail Address ___________________________________________________________________________________
| Select One Type of Membership | Individual (new) | $20.00 |
| (Enclose check or money order | Individual (renewal) | $15.00 |
| for the indicated amount.) | Household (new) | $25.00 |
| Household (renewal) | $20.00 |
Children of NCFC members who are dependent minors and living at home may accompany parents on any trip EXCEPT PCS–Lee Creek or where otherwise noted. Only 15 positions on the PCS–Lee Creek trip are available to members who reside outside of North Carolina. Memberships are effective from January through December of the year (or portion of the year) of the date of application. For example, persons joining in August will need to renew their membership 5 months later in January.
NCFC Liability Statement
The Undersigned hereby acknowledges his/her understanding that fossil collecting is an inherently dangerous activity which can result in serious bodily injury or death, and/or property damage and hereby confirms his/her voluntary assumption of the risk of such injury, death or damage. The Undersigned, in return for the privilege of attending field trips Related to the collection of and/or study of fossils, or any other event or activity conducted or hosted by the North Carolina Fossil Club (NCFC), hereinafter collectively and individually referred to as "NCFC Events", hereby releases the NCFC, NCFC Board members and officers, NCFC Event leaders or organizers and hosts, landowners and mine or quarry operators from any and all liability claims resulting from injury to or death of the undersigned or his/her minor children or damage to his/her property resulting from any cause whatsoever related to participation in NCFC Events. The Undersigned agrees to comply with any and all rules and restrictions which may be communicated to the undersigned by the NCFC Event leader and/or landowner and mine or quarry operator and acknowledges that failure to comply will result in immediate expulsion from the premises. The Undersigned acknowledges that this release covers all NCFC Events and will remain in effect at all times unless or until it is revoked by written notice to the current President of the NCFC and receipt of such revocation is acknowledged.
The Undersigned further attests to his/her intent to be legally bound by affixing his /her signature to this release.
Name Signature Date _____________________________________________________________________
Name Signature Date _____________________________________________________________________
Mail To: North Carolina Fossil Club, P.O. Box 13075, Research Triangle Park, North Carolina 27709