NORTHERN CALIFORNIA ALASKAN MALAMUTE ASSOCIATION
(LAST) (FIRST) (LAST) (FIRST)
(8-17 YEARS)
ADDRESS:______________________________________________________CITY:_____________________
STATE:___________ZIP:______________PHONE:_____________________HM_____________________WK
E-MAIL ADDRESS:______________________________OCCUPATIONS:______________________________
REGISTERED NAME OF ALASKAN MALAMUTE: (IF ANY)_______________________________________
.___________________________________________________________________________________________
INDICATE ANY DOGS CO-OWNED__________________________________________________________
BREEDERS NAME & ADDRESS_____________________________________________________________
ARE YOU A MEMBER OF ANY OTHER DOG CLUBS OR ASSOCIATIONS: (IF YES, PLEASE LIST)_______
WHY ARE YOU INTERESTED IN JOINING THE N.C.A.M.A.______________________________________
HOW LONG HAVE YOU BEEN INVOLVED IN THE BREED:____________________________________
WHAT KIND OF ACTIVITIES WOULD INTEREST YOU:_______________________________________
WILL YOU ATTEND VARIOUS EVENTS AND ACTIVITIES DURING THE YEAR:__________________
WHAT PERSON OR SOURCE REFERRED YOU FOR MEMBERSHIP:_______________________________
YOUR 2 N.C.A.M.A. SPONSORS ARE:
1)____________________________________ 2) ______________________________________
DUES: ACTIVE MEMBERSHIP
$40.00 (FAMILY)
RENEWAL $25.00 (SINGLE)
$35.00 (FAMILY)
JUNIOR MEMBER $20.00 (Not joining as part of a family)
8-17 years old
* ASSOCIATE MEMBER $20.00 (Per household)
* Does not have voting privileges
I hereby apply for membership in the Northern California Alaska Malamute Association, (Herein after N.C.A.M.A.) I recognize that N.C.A.M.A. is a private, non-profit club. I agree to abide by the N.C.A.M.A.’s Constitution, By-Laws, rules and regulations and shall subscribe to its Code of Ethics. Regarding all activities relating to my membership in N.C.A.M.A., including any charges of misconduct that may be proffered against me by another N.C.A.M.A. member, I acknowledge and accept the jurisdiction of the N.C.A.M.A. Board of Directors as the body designated to manage the affairs of N.C.A.M.A. and resolve disciplinary actions pursuant to the Club’s Constitution and By-Laws.
In consideration of being granted membership in N.C.A.M.A., I hereby agree to hold harmless and indemnify N.C.A.M.A. its Officers, and Board of Directors from any demands, court costs, attorneys fees and all other expenses incurred in the defense of any action I may bring, or which is brought on my behalf, singularly or in conjunction with others, and against N.C.A.M.A., it’s Officers and board of Directors, and upon which I prove unsuccessful upon the merits.
Additionally, in consideration of being granted membership in the N.C.A.M.A., I hereby release, discharge and agree to hold harmless and indemnify each individual Officer, member of the Board of Directors, and member of any trial Board duly appointed by the Board of Directors regarding any reasonable actions taken by them in their designated corporate capacities, from any and all liability, claims, demands, court costs, attorney’s fees and other expenses arising as a result of any action which I may bring, or which is brought in my behalf, singularly or in conjunction with others, which is brought against any of them, and upon which I prove unsuccessful upon the merits.
In consideration for being provided with N.C.A.M.A.’s Membership Application packet, and for the processing of my Application for Membership, should I choose to apply, I hereby agree that if I alone or with others, bring any type of administrative or judicial action against N.C.A.M.A., it’s Officers, and Board of Directors, jointly or severally, in any manner relating to or regarding the processing, approval, denial or rejection of my application for membership and if I prove unsuccessful upon the merits of my claim, I shall pay all costs and expenses, including attorney’s fees, incurred by N.C.A.M.A., it’s Officers and Board of Director, or any of them, in defense of or in response to that action.
I HAVE READ AND FULLY UNDERSTAND THIS WAIVER AND RELEASE OF LIABILITY AND INDEMNITY AGREEMENT, AND FREELY AND WILLINGLY CONSENT TO ITS TERMS AND CONDITIONS.
NAME:_______________________________________________________________________DATE:______________
NAME:_______________________________________________________________________DATE:______________
NAME:_______________________________________________________________________DATE:______________
Junior’s signature required if sole applicant.
NAME:_______________________________________________________________________DATE:______________
Adult’s signature allowing junior member to join as sole applicant.
PLEASE RETURN YOUR APPLICATION WITH DUES TO:
TJ Plutchak
8671 Blue Jay Way
Citrus Heights CA 95610
(916) 206-0694
THE HOWLER: The club’s newsletter, is published monthly. We encourage members to submit articles, opinions,
ideas and Alaskan Malamute experiences and stories.