Membership Form

Thank You for Supporting Nastawgan Trails Inc!

Personal information (please print)

Last Name(s):_________________________________ First:________________________

Mailing Address:______________________________________________________________

City:___________________________________ Prov./State:___________________

Postal / Zip Code:___________ Email:___________________________________

Phone:(_____)______________ ( Email for all notifications? Circle one of Yes or No )

Memberships available (please check one):

Individual: __ 1 year $10.00 __ 5 year $ 40.00 __ lifetime $200.00

Family: __ 1 year $25.00 __ 5 year $100.00 __ lifetime $500.00

Corporate: __ bronze $100.00 __ silver $450.00 __ gold $1000.00

Interests :

a) Please check as many as apply

__hiking __cycling __canoeing __snowshoeing __Xcountry skiing

__trail maintenance __guiding an outing __other: __________________________

b) difficulty level : __easy __intermediate __ advanced

c) I may be interested in leading an outing: __yes __no __maybe

Your comments or suggestions are welcomed: (use flip side if necessary)

I acknowledge that preparation for, and safety, while hiking, or involvement in organized, or promoted, Nastawgan Trails Inc. activities, are my sole responsibility. I herein waive Nastawgan Trails Inc., or any individual member, from responsibility for my, and any minor dependents, preparedness, safety and losses that may be incurred.

 Signatures of those name above _______________________________ Date: ___________

Please read the objects of incorporation at www.nastawgantrails.com and submit with cheque payable to Nastawgan Trails Inc. at

P.O. Box 341 Temagami, Ontario, Canada, P0H 2H0

For office use

Membership received: ___/___/___ expiry:___/___/___ database:____ intials: _____

dd / mm / yydd / mm / yy rev 20061028