Great Outdoors - Palm Springs
Website - www.greatoutdoors.org/ps Membership Application
Great Outdoors sound great? How do I join? Fill in the form below on your computer, print the form, sign it and send the form along with a check
(made payable to Great Outdoors) for the appropriate dues to: Great Outdoors, P.O. Box 361, Palm Springs, CA 92263-0361
Request (Select Only One)
Yes. I want to join Great Outdoors. Please enter my membership in the category below.
I am not ready to join Great Outdoors, but would like additional information.
Renewal. Please choose a category below.
Category (Select Only One)
$25 Regular (Age 18 or older)
$20 Senior (Age 60 or older)
$40 Senior Couple (Both age 60 or older at 1 mailing address)
$45 Couple (At 1 mailing address)
Newsletter Delivery Option:
e-Mail (in .PDF format) or
Printed & Mailed
Applicant(s) Information: [You have to fill in those areas with an asterisk (*)]
*Full Name
Birthdate
eMail
2nd Applicant
Birthdate
eMail
*Address
*City
*State
*Zip
*Telephone
WAIVER OF LIABILITY - I am aware that my participation in GREAT OUTDOORS may include
potentially hazardous activities and I am voluntarily participating in these activities with that knowledge
and the understanding that I will use my own best judgment to avoid injury to myself and others. I agree
to follow the directions of the trip leader and abide by the rules of the facility I am using. I hereby
release GREAT OUTDOORS, including its officers, trail or trip leaders, agents or other persons working
with said organization from any liability for injuries, physical or mental, which I may suffer by
reason of any participation in these activities. I recognize in waiving this liability that I am
assuming sole responsibility for my actions and cannot blame any injuries on any other persons connected
with the GREAT OUTDOORS.
MEDICAL RELEASE AND ASSIGNMENT - I hereby agree to assume full financial responsibility for any and
all bills incurred by me for medical treatment as the result or my participation in this GREAT OUTDOORS
activity. In the event that I am unable to consent to medical care, I hereby authorize the trip leader to
consent to emergency medical treatment for me, including hospitalization and surgery, as may best be determined
under the circumstances.