Application Form for Membership of the Irish Christian Mountaineering Club


(This form can be printed or downloaded in doc or pdf format.)

Surname
First Name
Tel No
Address
Church Association (if any)
E-Mail
Emergency Contact Name
Contact Tel No
Relationship to you
Walking / Climbing / Mountaineering experience
 
 
 
Why would you like to be part of a Christian Walking / Mountaineering Club?
 
 
 
Would you be willing to organise events in your area? Yes / No
How did you hear about the ICMC ?
 
 
 
Would you object to your personal details, outlined above, being placed in a members list and thereby accessible to other members of the club? (If the answer is Yes, we will not include your name on lists distributed to other club members.) Yes / No
Do you agree with our Statement of Faith : I acknowledge my need of Jesus Christ as my personal Saviour and put my trust in Him. I seek to follow Him in my daily life as outlined in the Bible. Yes / No
I understand that climbing, mountaineering and hill-walking are potentially hazardous activities and I accept that both members and their guests attend Club events at their own risk. I agree to abide by Club Policy on the booking of accommodation and I am willing to accept responsibility for loss or damage to property incurred by me during Club activities.

Signature
Date
Membership Fee (please circle one of the following and submit payment with application; a receipt will be sent to you):
  • Member € 35.00
  • Students and un-waged € 20.00
  • Family Membership € 60.00
    Two parents and children up to the age of 18 years. Please list names here:

Please return this form to:
Martin McCormack, Irish Christian Mountaineering Club, 24 Esker Meadow Lawns, Lucan, Co. Dublin
Telephone: 087-979 3482
E-mail: irelandwalk@eircom.net
Most of the fee will be used to register you with the Irish Mountaineering Council which supplies you with insurance and a quarterly magazine.
Climbing and mountaineering are activities with a danger of personal injury or even death. Participants in ICMC activities should be aware of this, be willing to accept the risks and be responsible for their own actions and involvement.