CVGC Application Cordillera Vail Gondola Club Application Applicant's Name* First Last Primary Physical Address* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Primary Mailing Address Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Secondary Physical Address Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Secondary Mailing Address Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Primary Phone*Cell PhoneEmail* Name of Spouse/Significant Other on Membership First Last Spouse Primary PhoneSpouse Cell PhoneSpouse Email Authorized Family MembersFamily members (under the age of 23 yrs old) authorized to use the Cordillera Vail Club Membership:Name First Last Birth Date MM slash DD slash YYYY Name First Last Birth Date MM slash DD slash YYYY Name First Last Birth Date MM slash DD slash YYYY Name First Last Birth Date MM slash DD slash YYYY Name First Last Birth Date MM slash DD slash YYYY Name First Last Birth Date MM slash DD slash YYYY Acknowledgments & DisclaimersThe undersigned does hereby acknowledge, accept and understand all of the following: 1. The undersigned desires to become a member of the Cordillera Vail Gondola Club in accordance with the Membership Plan and all Rules and Regulations as they may exist from time to time. 2. The undersigned acknowledges receipt of the Membership Plan and the Rules and Regulations of the Cordillera Vail Gondola Club; and further understands, accepts and agrees to be bound by all terms, conditions and provisions of the Membership Plan and Rules and Regulations as they may exist from time to time, including without limitation provisions concerning payment of dues, initiation fees and other charges. 3. The undersigned acknowledges that the Rules and Regulations of the Cordillera Vail Gondola Club, including without limitation its hours of operation, may be changed at any time and without warning or notice to members by the Cordillera Vail Gondola Club at the Club’s sole discretion. 4. This application shall not be accepted for consideration unless and until the undersigned provides the Initiation Fee (as defined in the Membership Plan) in a form acceptable to the Cordillera Vail Gondola Club in the Club’s sole discretion. 5. Applicant affirms and represents that applicant meets all requirements of membership in the Membership Plan. Signature of ApplicantDate MM slash DD slash YYYY Δ