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Lehigh Valley Kayak & Canoe Club Membership Form

Mail Form and Waiver along with check payable to "Lehigh Valley Canoe Club, Inc." to:
Lehigh Valley Canoe Club, Inc., PO Box 20194, Lehigh Valley, PA 18002

Please type directly on screen form before printing:

Date:	/ / 20
Check	New Member      Renewal      Change In Member Information
Dues:	Individual  $ 15    Family $ 15
Name1:		Age:	yrs
Name2:		Age:	yrs
Name3:		Age:	yrs
Name4:		Age:	yrs
Name5:		Age:	yrs
Address:
City:
State:
Zip:
Home #:
Work #:
E-mail:

You must also print out and sign the LVCC Annual  Waiver (Open in new frame).