MEMBERSHIP - Jazz Ma Tazz Ski & Social Club

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Membership Application

Email *

Name (first and last) *

Home Address (street number, city, state, zip) *

Phone number (area code + 6 digit number) *

Renewal or New Membership *

Gender *

Male

Female

Other

Prefer not to say

Age Group *

18 - 30

31 - 50

51 - 64

65+

Snowsport Interest *

Skier

Snowboard

both

other (example novice, cross country, etc. or none of the above)

Type of Membership (FY Aug 1st - July 31st) Dues and ALL fees are non refundable *

Individual = $75 (plus applicable processing fees)

Out of State = $50 (plus applicable processing fees)

Family = $85 (plus applicable processing fees)

If family membership, list each family members (name, age)

Emergency Contact (name, phone number, email) *

How did you hear about Jazz Ma Tazz (Facebook, referred by, etc.) *

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