Keel-Hauler Membership Application
Please fill out all applicable information

Read Waiver "Member's Mutual Agreement for Protection from Liability" at this Link - Read the Waiver
I agree to liability Waiver
I agree to liability Waiver
I am a current club member
I am a current club member
Last Name
First Name
Spouse or Other Last Name
Spouse or Other First Name
Address
City
State
zipcode
zip+4
Choose all paddling interests.
Paddling Interest - White Water
Paddling Interest - WW
Paddling Interest - Sea Kayaking
Paddling Interest - SK
Paddling Interest - Flat Water
Paddling Interest - FW
Paddling Interest - Canoe Camping
Paddling Interest - CC
Home Phone
Cell Phone
Work Phone
List Work or Cell for yearbook
CellWork
Child Name/Birth Year
Primary E-Mail
Alternate E-Mail
Share My name
Share only with KHCC Board Approval. Do not Share my Information with anyone.
You will receive a password by e-mail each month unless you include a comment below explaining why you require a printed copy of the newsletter
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Comment
Membership Cost and Terms

* Club Membership Year ends Oct 1st no matter when you join.
* Membership Dues are $20.00 Per Year.
* If you join from July 1st to August 15th dues are only $10.00.
* Our Yearbook & Roster is distributed to all paid members in February
* New members will be mailed a copy until we run out.
* The December newsletter is the last one that you will receive until you renew.

Web Author:  John Kobak;  Treasurer - Sam Reynolds
Copyright 2008-16 Keel Haulers Canoe Club.  All rights reserved.
Revised:06/27/16