Mackinaw Canoe Club
Membership Application

Your Club membership gives you a vote at our annual meeting and entitles you to receive
our newsletters with trip schedules and reports, announcements about paddling events,
sale items and notices concerning river issues, as well as access to our members-only website.
You will also receive up-to-the minute news by email.

Would you prefer to receive the newsletter (Choose one):
US mail_______    Email only_______     Or both US mail and emailed to you_________

Name: ___________________________________________________

Other family member names:___________________________________

Address: _________________________________________________

City, State and Zip Code:_____________________________________

Home Phone:______________________________________________

Cell Phone/Other:___________________________________________

E-mail address (please print carefully):

_________________________________________________________

All adults must sign the following:

      I agree that I, the undersigned, for and on behalf of myself and any minor child who may accompany me, will take part in the Mackinaw Canoe Club activities at my own risk. I will not hold the Club, its officers, board members, trip-leaders, or any of its members responsible for any injuries or property loss that I or any member of my family may incur while taking part in Club activities.

Signature: _______________________________________

Signature: _______________________________________

Mackinaw Canoe Club - individual or family membership, $15.00:__________

Please mail your check with your completed Mackinaw Canoe Club application to:
Mackinaw Canoe Club, c/o Marilyn Black, RR 2 Box 5, Clinton, IL. 61727

Thank you for renewing your membership! SYOTR!

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