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Student/Senior Membership
First Name:
Last Name:
Address:
City:
State:
Zip:
Phone:
Email:
Person to notify in an emergency:
Relationship:
Emergency Phone:
By submitting this form I understand that I am applying for a free student or retired senior membership in the Maple Valley Astronomical Society (MVAS).

I also understand that the information given on this page is for MVAS use only. This information will not be given to anyone outside MVAS without written authorization from me (with the exception of law enforcement officials) and will never be used or sold for marketing purposes.

I may receive email messages occasionally from MVAS officers. This is only for communication purposes for such things as last minute event rescheduling or location changes, and any urgent MVAS related information. Such communication will be kept to a minimum and only happen as needed. Most MVAS communication will happen on the free bulletin boards provided by the MVAS Web site and at MVAS meetings.

I agree that when I attend any MVAS events I do so at my own risk. I will not hold MVAS nor its officers nor its members responsible in any way for any injury, illness, or damages of any kind that I might experience as a result of attending MVAS events. I have provided emergency contact information for MVAS representatives to use should I become injured, ill, or incapacitated. Supplying this information to MVAS does not imply any responsibility on their part for my health or safety.

I agree to conduct myself in accordance with the club's policy when attending club meetings, events, and/or representing the club at public events.

IMPORTANT: If you are under 18 years of age you must also enter your parent's or legal guardian's member ID number (which means they have to sign up first, then put their number here when you sign up):