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Thank you for  your interest in joining the Midwest Camaro Club.  Annual dues are $25.  
To complete your registration in our club please mail payment as follows: 

Midwest Camaro Club 		
P.O. Box 241426
Omaha, NE 68124-5426

Once dues are received we will add your name to our club roster which will put you 
on the mailing list and you will begin receiving our monthly Newsletter.  The Newsletter 
will give you information on club meetings and all recreational activities.  In addition 
if you wish we will add your email address to our group email list.  This list gives 
reminders of meeting, activities and at times has some For Sale items as well as  
useless banter.  Please also provide the following information so that we may fill in the  
club database.   Thanks again for your interest.

Midwest Camaro Club
Membership Director
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                        New Member Registration

Name:  __________________________________________________________________
Address:  ________________________________________________________________
City / State / Zip:  _________________________________________________________
Phone:  _________________________   Birth Month: _____________________

Spouse / Sig Other:  _____________________________________________________
Car - Make / Model / Year:  ________________________________________________
E-Mail Address: _________________________________________________________

LIABILITY:  In consideration of the acceptance of the right to participate, members, by execution of this application, release and discharge the Midwest Camaro Club their officers, directors, employees, agents, representatives, and anyone else connected with the management or conduct of the Midwest Camaro Club events of and from any and all known and unknown damages, injuries, loses, judgments and or claims from any causes whatsoever that may be suffered by any member to his person or property.  Further, each member expressly agrees to indemnity all of the foregoing entities, firms, persons and bodies of and from any and all liability occasioned or resulting from the conduct of members or any participant assisting or cooperating with members or participants and under the direction or control of a member or participant at any Midwest Camaro Club event or activity.

New members 18 years and older may sign below in acceptance of this agreement.  Those under 18 years must have a parent or legal guardian sign this application.

Member Signature:                                                    Legal Guardian Signature: 

__________________________________                            _________________________________

I have read and agree to the terms above.                                I have read and agree to the terms above.