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[Pages:1]Ways to Apply

MAIL check, money order, or credit card information to: Sierra Club Outings Department 2101 Webster St., Suite 1300 Oakland, CA 94612

Credit Card (Visa & MasterCard) Only CALL: 415-977-5522 (M?F, 8:30am?5pm PST) FAX: 510-208-3140 WEB: adventure-travel

Please read our Reservation and Cancellation Policy before registering!

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Outings Reservation Form

.

MEMBERSHIP NUMBER

TRIP NUMBER

TRIP NAME

DEPARTURE DATE

YOUR NAME STREET ADDRESS

YOUR HOME PHONE

(

)

EMAIL ADDRESS

YOUR WORK PHONE

(

)

CITY

STATE

ZIP

PLEASE PRINT YOUR NAME AND THE NAMES OF OTHER PEOPLE IN YOUR PARTY 1.

IS THIS A NEW ADDRESS?

YES NO

PER PERSON COST

MEMBERSHIP NUMBER

PLEASE USE A SEPARATE SHEET TO LIST ADDITIONAL PARTY MEMBERS' ADDRESSES

BIRTHDATE (Month/Day/Year)

RELATIONSHIP

SELF

2.

3.

4. TOTAL AMOUNT OF DEPOSIT

$

TOTAL MEMBERSHIP AMOUNT ENCLOSED (IF ANY)

$

TOTAL PAYMENT ENCLOSED

$

EMERGENCY CONTACT WHILE ON THE TRIP (NAME AND PHONE NUMBER)

THE FULL AMOUNT OF THE TRIP FEE IS DUE IF YOUR RESERVATION IS MADE LESS THAN 90 DAYS PRIOR TO TRIP DEPARTURE.

Check Money Order VISA MasterCard

CARDHOLDER NAME CARD NUMBER

SIGNATURE

EXPIRATION DATE

If you pay your deposit by credit card, we will automatically charge that credit card with the final payment 90 days before the trip starts. Make checks or money orders payable to Sierra Club and mail to: Sierra Club Outings Department, 2101 Webster St., Suite 1300, Oakland, CA 94612.

--------------------------------------------------------------------------------------------------------------------------------------------------

Outings Reservation Form

.

MEMBERSHIP NUMBER

TRIP NUMBER

TRIP NAME

DEPARTURE DATE

YOUR NAME STREET ADDRESS

YOUR HOME PHONE

(

)

EMAIL ADDRESS

YOUR WORK PHONE

(

)

CITY

STATE

ZIP

PLEASE PRINT YOUR NAME AND THE NAMES OF OTHER PEOPLE IN YOUR PARTY 1.

IS THIS A NEW ADDRESS?

YES NO

PER PERSON COST

MEMBERSHIP NUMBER

PLEASE USE A SEPARATE SHEET TO LIST ADDITIONAL PARTY MEMBERS' ADDRESSES

BIRTHDATE (Month/Day/Year)

RELATIONSHIP

SELF

2.

3.

4. TOTAL AMOUNT OF DEPOSIT

$

TOTAL MEMBERSHIP AMOUNT ENCLOSED (IF ANY)

$

TOTAL PAYMENT ENCLOSED

$

EMERGENCY CONTACT WHILE ON THE TRIP (NAME AND PHONE NUMBER)

THE FULL AMOUNT OF THE TRIP FEE IS DUE IF YOUR RESERVATION IS MADE LESS THAN 90 DAYS PRIOR TO TRIP DEPARTURE.

Check

CARDHOLDER NAME

SIGNATURE

Money Order VISA

CARD NUMBER

EXPIRATION DATE

MasterCard

If you pay your deposit by credit card, we will automatically charge that credit card with the final payment 90 days before the trip starts. Make checks or money orders payable to Sierra Club and mail to: Sierra Club Outings Department, 2101 Webster St., Suite 1300, Oakland, CA 94612

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