Fun, Fit and Over Fifty Club
Membership Application or Renewal
PO Box 41, Richland, WA 99352
(http://www.ffofc.org)
To join or renew your membership please complete this application and mail to the address above
Remember to include your signature(s) on the waiver (below) and your dues payment
The dues are $15 per person per year starting April 1st (Dues paid after 12/31 cover the following year)
If you are a new member, let us know what activities interest you. We also hope you will consider serving the club by participating on one of our standing committees or leading an event.
Please tell us what activities would interest you
q Hiking, Walking q Nordic Skiing, Snowshoe q Tennis q Social Activitiesq Biking, Road or Mountain q Alpine Skiing q Golf q Tours, Books, Lectures
q Canoe, Kayaking. Rafting q Fishing, Hunting q Field Sports q Travel
q RVing/Camping q Photography q Bowling q Communications
q Other q Activity Committee Participation
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Name 1: (please print) Name 2: (please print)
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E-mail Address: 1 * E-mail Address: 2 * if different from 1
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Phone (s) (home and/or cell): 1 Phone (s) (home and/or cell): 2 if different from 1
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Address (Street or PO Box) City/State/Zip
*Email address for electronic notification per RCW 24.03.009
Waiver, Safety Affirmation and Release
(**Must be signed with membership application**)
In consideration of the acceptance of this membership application and being allowed to participate in the Fun, Fit and Over 50 Club activities, I hereby personally assume all risks in connection with those activities and I further agree to forever release, discharge, waive, save and hold harmless the Fun, Fit and Over 50 Club, its officers, the activity leaders, sponsors and any agents from any claim by me, or by my family, estate, heirs or assigns arising out of my participation in these activities. This includes, but is not limited to, waiving any and all rights, demands, or claims for damages and causes for suits or actions known or unknown, and further includes but is not limited to medical expenses or other expenses in the event of accidents, illness, other incapacity, death or damage to property. I further state that I am legally competent to sign this Affirmation, Waiver and Release. I understand that the terms of this document are contractual and not a mere recital and I have executed this document as my own free act. I attest and verify that I have full knowledge of the risks involved in participation of Club activities. I have fully informed myself of the contents of the Affirmation, Waiver and release by reading it before signing below.
Signature 1 Date
Signature 2 Date
Effective Date 1/01/12