Salem-Keizer Pickleball 2022-2023

Membership Sign-up/Renewal Form

Yes, I want to become a member of the Salem-Keizer Pickleball Club.

Name
Address
City	State	Zip Code
Phone
Email

Yearly Membership runs from September 1^st, 2022 through August 31, 2023. There will be no proration.

I hereby pledge to abide by all rules and regulations set forth by the Salem-Keizer Pickleball.

I hereby release and discharge the Salem-Keizer Pickleball and their officers from any and all actions, causes of action, claims and demands for, upon, or by reason of any damage, loss, personal injury or death which may result from or in connection with my participation of any nature in any of the Salem-Keizer Pickleball activities, including COVID-19. I understand that this release is binding upon me, my assigns, my personal representatives and heirs.

Signature:___________________________   Date:________________

Amount Paid _________ Date Paid__________

Choose one: Check____ Zelle______Cash_______

Zelle: 503-302-4818

Mail Checks and Completed Forms to Michelle McDermeit, Treasurer, P.O. Box 20148, Keizer, OR 97307. Make checks payable to SKPC

VISION STATEMENT: Promote the game of pickleball within the Salem-Keizer community.

MISSION STATEMENT: As a non-profit, volunteer-based organization, we will foster the growth of pickleball within the Salem-Keizer community. We will connect with individuals, groups, organizations, and local governments to develop fun and competitive opportunities for players of all ages.

Salem-Keizer Pickleball Club is a harassment, discrimination & bullying free zone at all times.