Welcome to www.joeoblenis.com

2010 Superior Kayak & Canoe Club Membership Form:

Name: ____________________________________________________________

Individual or Family: (Circle one) Number of Applicants: _________

Address:_________________________________________________________

________________________________________________________________

Telephone: Home: _________________Cell/Work_______________________

                       
E-mail address: ___________________________________________________

Level of paddling experience: (Circle one)

 Beginner           Intermediate                 Advanced

Are you interested in any of the following? (Circle all that are applicable below)

Willing to organize/ lead some trips         Day Trips          Weekend Events

Help with a newsletter                            Contribute Photos for Website

Act as a Contact Person                          

Other (Open to suggestions…. ­­­­­­­­­­­­­­­­­­­­­­­­­

Signature: __________________________________

Please fill out the Membership form AND the Waiver Form.

Membership fee is $15.00 for individuals and $20.00 for a Family membership.

Cheques can be made out to Joe O'Blenis

Forms and fees can be mailed to:

Joe O'Blenis

108 Glendale Crescent

Thunder Bay ON

P7C-1N1