HPD_form_membership

High Plains Drifters Fly Fishing Club Membership Application
Membership Type

New Membership (I have not been a HPD Member before)Renewal
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
By giving my email address, I understand and agree that I am opting into the HPD mailing list for email or other communication from board members regarding club business or items of interest related to the flyfishing community. The official method of communication for all HPD club business is via email to addresses provided.
How did you hear about HPD?*
Please check areas in which you have an interest to become involved now or at a later time:

MeetingsConservationPicnic/Christmas PartyCasting ClassesKids Day (Major Event)Web SiteFund Raising EventsFishing TripsMentoring/Clinics/ClassesNewsletterFly Tying Classes/DemosBoard of Directors/Club Officers
Hold Harmless Agreement

I fully understand the risks and dangers involved in fly fishing, particularly when wading or boating in rivers and lakes. In consideration of the right granted to participate in HPD events including trips, picnics, outreach programs, and meetings I, the undersigned, acknowledge that I do so entirely upon my own agree to remove, fully release, hold harmless, and forever discharge High Plains Drifters, the Eastern Rocky Mountain Council, and Fly Fishers International and all their officers and volunteers from any and all claims, demands, actions, or causes of actions on account of any injury or death to me or my family members while participating in the above-named activities.

I have read this agreement and fully understand the release I am giving. I further attest that I am an adult capable of consenting to this agreement.
Name of Applicant*
Signature of Applicant or Guardian (if under 18)*

Clear
Date*

MonthDayYear
Date
After submitting this membership form/waiver you need to complete the checkout process on the website and pay for your membership.
Should be Empty:

High Plains Drifters Fly Fishing Club Membership Application