Evergreen Membership and League Registration Print Form

Fill in the form on-line and print it! No Data is transmitted using this on-line PRINT Form!


First Name		Last Name
Address
City		State		Zip
Country		Email
Home Phone		Cell Phone
Allow my contact information to be shared with other members
*Junior Information* A Junior under 18 years of age must have a parent or guardian sign the ECC Club Waiver Form A Junior is any player who is less than 21 years of age at any time during the 30th day of June of the year immediately preceding the year of the competition.		DOB (Junior's Only)
Team Members		Wheelchair Curler		Gender	Female Male
Curling Experience	1 year or less 2-5 years More than 5 years	Position	Lead Second Vice Skip Skip Any
Curling Instruction	I have never curled, or I would like basic curling instruction.
Please place your mouse here and read the note!

1. Evergreen Curling Club Membership FEE Options

To play in a league, ECCMembership is required. 1/2 year membership expires September, 2010. Full year membership expires September, 2011.

Membership Fees Choose one

2. League FEES

Mail to:
Evergreen Curling Club
Treasurer
P.O. Box 12162
Portland OR 97212.
Receipts issued upon request.
Include BOTH Forms!

League Fees --Choose One

$ Total Fees

Make check payable to: The Evergreen Curling Club

For office use: Received on (date) Check No. Cash

Don't forget to fill in and print the Waiver Form

If you have trouble with this form, contact

You are not guaranteed placement until money is received. Placement is not guaranteed by payment. We will do our best to place you in the league of your preference. If you prefer you can register on-line at the join page.

ECC reserves the right to modify or cancel a league for any reason, including but not limited to insufficient number of registrants. If this occurs, registrants may request a refund or a transfer to another available league.