CVTA Membership Form

CVTA Membership Registration

(* = required field)

Please tell us if you are a new member, or if you are renewing your membership:

*Registration Type:

New Membership Renewal

Please select the type of membership you want:

*Membership Type:

Individual $30
Family $35
Senior (50 yrs and older) $25

Please enter contact info for yourself:

*First Name

*Last Name

*Phone
(format:xxx-xxx-xxxx)

*Email

*NTRP Rating

*Gender

Age

Address:

*Street:

*City:

*State:

*ZipCode:

Miscellaneous:

*Photo Release:

Do you give the CVTA permission to use photos which include you or family members in CVTA produced publications?
Yes No

Volunteer:

The CVTA depends on its volunteers to help run the various events it sponsors. Please indicate if you are willing to serve as a volunteer.
Yes No

Payment Method:

*Payment Method:

Check Credit Card (via PayPal)