2024 Member Registration Form

Ready to Join
To register, simply fill out one form for each person you are registering.
We’re looking forward to seeing you!
* Please note: Any item marked with a red asterisk is required.

** MEMBERSHIP FEES ARE NON REFUNDABLE**
Step 1: New or Returning Member
New or Returning Member*
Please select one of the options.
- A new member
- A renewing member
New Member – Who Referred You
If you are a NEW member, please indicate the first name and last name of the person who referred you.
Renewing Member – Personal Data That Has Changed
Please indicate the item that has changed. For example, type the word Address or Cell Phone number, etc.

Step 2: Personal Information
First Name*
Last Name*
Address*
City*
Postal Code*
Make sure your email address is correct! Once you click Submit, the system will email you a complete copy of your application. If you do not get the confirmation, please email Jan Stringer at this email address: info@skicousi.ca.
Email*
Enter Email Confirm Email
Home Phone Number*
If you do not have a home phone number, type in zeros.
Cell Phone Number*
If you do not have a cell phone number, type in zeros.
Male or Female
This information will help us plan the best social events for the current members.
- Male
- Female
Age Verification*
- I affirm that I am 18 years of age or older

Step 4: Emergency Contact Information
Emergency Contact Name*
Emergency Contact Telephone Number*

Step 5: Skicousi and Your Privacy
Skicousi Privacy Policy*

Please read before you agree. The information you submit will be stored on our servers and is subject to Skicousi’s Privacy Policy. Skicousi is in compliance with the Federal Personal Information Protection and Electronic Documents Act (PIPEDA), which came into effect January 1st, 2001. As a result, Skicousi is subject to stringent guidelines regarding the collection, storage and disclosure of private and personal information collected on your application form.
- I agree to the terms of the Skicousi Privacy Policy
Contact Information*
Would you like to have your name and contact information included in the Skicousi Membership Contact List? This list is used to send you emails to keep you informed of upcoming Skicousi events. You can contact us at any time to change this option.
- Yes
- No
Photography Permission*
Please indicate if you give Skicousi permission to use your photograph on the Skicousi website and on the Skicousi reminder emails.
- Yes
- No

Step 6: Waiver and Release of Liability
Agree with Waiver*
- I agree to the terms of the waiver displayed.
Waiver and Release of Liability

In consideration of being allowed to participate in any way in the Skicousi Ski Club, athletic/sports program, related events and activities, the undersigned acknowledges, appreciates, and agrees that:

1. The risk of injury from the activities involved in this programs is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and,

2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, BOTH KNOWN AND UNKNOWN, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,

3. Willingly agree to comply with the stated and customary terms and conditions for participation. If however I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and,

4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Skicousi Ski Club, their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, volunteers, and, if applicable, owners and lessors of premises used to conduct the event ("Releasees"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, OR loss or damage to person or property, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY AGREEING TO IT, AND AGREE TO IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

Step 7: Membership Payment
Current Prices*
- $90: Annual Membership for new or renewing members
- $105: Annual Membership for renewing members plus replacement name tag
- $15: Replacement name tag only
eTransfer Payment – etransfers.skicousi@gmail.com*
The only payment method is to send an eTransfer. **** PLEASE eTRANSFER THE REGISTRATION FEE AT THE TIME OF REGISTRATION. **** CONFIRMATION OF REGISTRATION IS YOUR eTRANSFER EMAIL CONFIRMATION. **** ************ In your eTransfer “Message Box” please indicate the names of the members you are registering.
**** MEMBERSHIP FEES ARE NON-REFUNDABLE.
- I will send an eTransfer payment to etransfers.skicousi@gmail.com (PLEASE ENSURE THE EMAIL ADDRESS IS CORRECT IN YOUR ETRANSFER).
Exact Name that Appears on Your Bank Account*
Please indicate the exact name that is on the bank account that you will use to send the eTransfer amount to pay for this membership. This information will be used to match the Membership registration form data with your eTransfer data.
Paying for Multiple Members
If you are sending an eTransfer for multiple members, please type in all the member’s names in the text box below. **** PLEASE eTRANSFER THE REGISTRATION FEE AT THE TIME OF REGISTRATION. **** In the eTransfer “Message Box” please indicate the names of the members you are registering.

Step 8: Submit This Form
Please go to your bank website and send your membership payment by eTransfer. Email address: etransfers.skicousi@gmail.com
Once you click the Submit button at the bottom of this page, we will record your registration. Please send your eTransfer.
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Phone
This field is for validation purposes and should be left unchanged.

2024 Member Registration Form

Step 1 of 7

Ready to Join

Step 1: New or Returning Member

Step 2: Personal Information

Step 4: Emergency Contact Information

Step 5: Skicousi and Your Privacy

Step 6: Waiver and Release of Liability

Step 7: Membership Payment

Step 8: Submit This Form