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Leeds Mountaineering Club Application Form

Full Name:
Address:
Postcode:
Tel (daytime):
Tel (evening):
Tel (mobile):
Email:
Over 18?:		Yes No
Contact Listing:		.
The club newsletter contains a members contact list showing members names, status (prov/full) and your choice of:		Email Phone Both None
Please provide a resume of your mountaineering experience including membership of other clubs:
Please list any medical problems or disabilities that fellow club members on a meet should know about (eg diabetes, epilepsy etc.) If none, then please state none:
I accept that climbing and mountaineering are activities with a danger of personal injury or death. I am aware of and shall accept these risks and wish to participate in these activities voluntarily and shall be responsible for my own actions and involvement.		Yes - I understand and accept these conditions No - I don't accept these conditions

James, Liz and Dave on Sgorr Dhonuill - Onich Meet