BISHOPSTOWN HILLWALKING CLUB (BHC) Membership Application Form 2009-2010

NAME (print):___________________________________________________________

POSTAL ADDRESS (print):________________________________________________________________

_______________________________________________________________________________________

I accept that Hillwalking is an activity with a danger of personal injury or death. I am aware of and accept these risks. I wish to participate in these activities voluntarily and undertake to be responsible for my own actions and involvement.

I declare that I am not suffering from any physical or mental condition that might affect others or me on any walk, and that I am not on medications. I will abide by BHC rules and Walk Leaders decisions at all times.

I understand that BHC reserves the right to accept or reject new applications and renewal applications.

SIGNATURE___________________________________________________;

TEL NO. (optional)_____________________________

M.C.I. Number: M____________; E-mail (Print)_________________________________________

NEXT OF KIN (Name & Telephone No.)_______________________________

New members: Previous Hillwalking experience, if any:___________________________

€ 45 to 31^st October 2010 (Cheques payable to BHC);

Renewal or New Member.

[Members of other MCI affiliated clubs can obtain reduced BHC membership rates. Send a copy of your MCI card to us for consideration].

[Beginners...Please note that when you join BHC, you are automatically joining the MCI - Mountaineering Council of Ireland. As well as receiving the MCI magazine 4 times a year, you are also getting a very basic insurance cover so that you can join our walks]

Accepted on behalf of BHC:______________________________;

Date:__________________________; Membership no._______

Send completed form & fees (cheques payable to BHC) to Sean Cotter, 45 Rossbrook, Model Farm Road, Cork City (Tel 021-4546194 answering machine, seancotter001@eircom.net) or hand to Walk Leader before the start of any walk or meet us at The River Bar in The Kingsley Hotel (opposite Cork County Hall) on Thursday evenings at 10 pm.