MEMBERSHIP APPLICATION Appalachian Telemark Association Membership Application for Ski Season 2026/2027 Leave this field empty Membership Type * Individual $40.00 Family $50.00 Youth (16 and under) $10.00 Names * Name Name Name Name Name Name Address * City * State * Zip * Phone 1 * Phone 2 Email 1 * Email 2 Subscribe me to ATA's email list Total: — ACKNOWLEDGEMENT OF RESPONSIBILITY AND RELEASE OF LIABILITY The Appalachian Telemark Association is a year-round social/sports/ski club providing a variety of activities for its members. Many of the club activities are, to a varying degree, hazardous. By making application for initial or renewal membership, I/we voluntarily assume all the risks involved. By assuming all risks involved, I/we agree to not hold APPALACHIAN TELEMARK ASSOCIATION, its officers or Board Members, trip organizers or activity coordinators liable for any accident or injury resulting from my (or other family members) participation in a club activity or use of administrators and person(al) representatives equipment. I/we have read this release in full and understand it, and hereby apply / renew for membership in the APPALACHIAN TELEMARK ASSOCIATION. I have read and acknowledge the release of liability above. * Signature * Signing for: Sign with mouse or finger Type my name Clear signature Date: October 17, 2026 Guardian (required for a youth member) Signature * Signing for: Sign with mouse or finger Type my name Clear signature Date: October 17, 2026 Guardian Signature * Signing for: Sign with mouse or finger Type my name Clear signature Date: October 17, 2026 Guardian Signature * Signing for: Sign with mouse or finger Type my name Clear signature Date: October 17, 2026 Guardian Signature * Signing for: Sign with mouse or finger Type my name Clear signature Date: October 17, 2026 Guardian Signature * Signing for: Sign with mouse or finger Type my name Clear signature Date: October 17, 2026 Guardian By signing, I agree that this electronic signature is the legal equivalent of my handwritten signature. Submit application