Blue Ridge Ski Council

Ski Club Registration form

Dues for coming year (runs May-April)  ($0.15 per member, but not less than $5.00 nor more than $35.00.

$5.00 penalty if registered after 15th of October, due to membership lapse.

Please send to: Steve Peirce BRSC Treasurer 19701 Golden Valley Lane Brookeville MD 20833

This registration is for the season:

Please provide the following Club information: areas in Yellow are required

Your Name
Your email
Club Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Club Phone
Club FAX
Club E-mail
Club URL

Please provide the following contact information for your club President:

Title
Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Work Phone
Home Phone
FAX
E-mail

Please provide the following contact information for your clubs BRSC  Delegate #1:

Title
Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail

Please provide the following contact information for your clubs BRSC  Delegate #2:

Title
Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail

Please provide the following contact information for your clubs Western Carnival leader:

Title
Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail

Please provide the following contact information for your clubs newsletter editor:

Title
Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
FAX
E-mail

Please provide the following contact information for your clubs Trips Chairperson:

Title
Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail

Please provide the following contact information your clubs Eurofest Leader:

Title
Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail

Please provide the following contact information for your clubs Race Coordinator:

Title
Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail