To: Georgia Orienteering Club
4738 City View Dr.
Forest Park, GA 30297
We hereby apply for a Youth Group membership in the Georgia Orienteering Club.
Group Name ______________________________________________________________
School Name _____________________________________________________________
-or- Scout Troop ___________________________________________________________
Adult Advisor/Contact _______________________________________________________
C/O _____________________________________________________________________
Street ___________________________________________________________________
City/State/Zip _____________________________________________________________
Phone(s) ________________________________________________________________
Email ___________________________________________________________________
Check One: __________ New/Renewing Group Membership
__________ Additions to current Group Membership
GAOC Youth Group dues: (due only if new or renewing group membership at this time)
Annual base rate equivalent to GAOC Family Membership dues ($15.00) = ________
Insurance fee and per club member fee required by USOF for each member:
Total number of individual membership permission/waivers attached ________ x $ 5.00 = ________
Equals total amount due to with this application (total all lines) ________
Make check payable to: Georgia Orienteering Club
Requirements:
In order to qualify for a Youth Group membership in the Georgia Orienteering Club, an organization must
fulfill the following conditions:
1. The group must be affiliated with a school or scout troop. All persons within the group membership must
be active students, members, instructors or leaders of the affiliated organization or parents actively assisting
the instructor or leader on a continuing basis.
2. The adult advisor/contact of the group must fill out this form and attach individual Youth Group
Membership Applications for each individual member which include permission and a waiver signed by the
youth's parent/guardian (adult membership ignore permission/waiver section). The forms are to be
submitted to the GAOC Treasurer all with a fee of $15 plus $5.00 per group member. Additional members
may be added at any time by the adult advisor/contact by following the same procedure.
3. GAOC group membership runs on the August 1st to July 31st year. GAOC group membership expire on
July 31st each year regardless of when the membership was initiated.
Rights of the Youth Group Membership:
Individuals within the GAOC Youth Group Membership are eligible for GAOC member discount at GAOC
local events.
2/16/2016
GEORGIA ORIENTEERING CLUB
Youth Group Membership Application
Individual Belonging To Member Group
GAOC Youth Group Membership is open to school groups and scout troops. Each group membership must
be renewed annually. All members of the group membership must be active students at the same school or
active members in the same scout troop or youth group. The adult advisor for the group applies for the
group membership and submits the individual applications. Each individual application must include a
signed parent/guardian's permission and waiver of liability for the individual youth to participate in GAOCsponsored orienteering events for the time period of the membership.
Group Name ___________________________________________________________________________
School Name __________________________________________________________________________
-orScout Troop ___________________________________________________________________________
Please Print. [ ] New member
[ ] Renewal
Date _________________ Year Born _____________ M/F ________
Name ________________________________________________________________________________
Street ________________________________________________________________________________
City/St/Zip ____________________________________________________________________________
Home Phone (_________)-_________-_____________
Email ________________________________________________________________________________
Waiver and Permission to Participate
Must be signed by parent or guardian for each applicant
In consideration of the acceptance of this application, intending to be legally bound, I do hereby for the
applicant, his parents/guardians, heirs, executors and administrators, waive and release any and all rights
and claims for damages I may have against the United States Orienteering Federation, the Georgia
Orienteering Club and its members, the Georgia State Parks, the school and/or scout group sponsoring this
membership, and other public and private land owners and lessees, their representatives, successors, and
assigns for any injuries resulting from events from the date of this application through the following July 31st.
I further attest that I recognize that participation in orienteering events may pose a risk of injury, and I attest
that the applicant accepts that risk and further attest that he/she is physically fit, able and qualified to
participate in orienteering events.
Name of applicant ______________________________________________________________________
Name of parent/guardian __________________________________ ______________________________
SIGNATURE parent/guardian _____________________________________________________________
Address questions via E Mail to rshannonhouse@comcast.net