Milton Keynes Mountaineering Club

Application for Membership

I (full name) ---------------------------------------------------------------------------

of (address) ---------------------------------------------------------------------------

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Apply for membership of Milton Keynes Mountaineering Club

• I agree to be bound by the Club’s current rules.
• I accept that mountaineering, hill walking and rock climbing are potentially dangerous activities and wish to participate in them voluntarily.
• I agree to waive claim for injury that may befall me due to the lack of reasonable care of the club or any of its members.

Signed --------------------------------------------------------Date--------------------------------

Signature of parent / guardian (if under 18) -----------------------------------------Date-----------

Full name of parent / guardian ---------------------------------------------------

Address -------------------------------------------------------------------------------------------

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I am interested in (please circle):

Rock climbing /Walking /Scrambling/Winter climbing /Mountaineering/Mountain biking/Other....................

Experience (Brief description only)

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If you would prefer your name and phone number not to appear on the club list of members please put an X in this box 

This list will be circulated to club members only.

Send to: Jo Astley, Membership Secretary, 20 Claremont Avenue, Stony Stratford, Milton Keynes tel 01908 563207

Sum received: £-------- Club official’s signature-------------------------------------------- date-----------