"*" indicates required fieldsApplication Status* New Member RenewalMembership Type* Individual ($55/yr) Family ($65/yr) Student ($25/yr)Family memberships cover all individuals living at the same physical address as listed on the application. All family members planning to enter competitions must be listed on this applicationStudents must present proof that they are currently enrolled in an educational institution. If you are using your school email address (must end in .edu) for your membership application you do not need to provide further proof. Otherwise, email a copy of your student ID to [email protected].Primary Account Holders Name* First Last Address* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Phone*Email* Enter Email Confirm Email List family member names and email addresses in the boxes below. These will be used to create their name tags, allow them to participate in competitions and keep them informed of club activities. You can add up to 4 family members.Family Member 1 - NameFamily Member 1 - Email* Family Member 2 - NameFamily Member 2 - Email* Family Member 3 - NameFamily Member 3 - Email* Family Member 4 - NameFamily Member 4 - Email* Payment Method* Debit/Credit/Paypal Check CashIf applying by mail, send check payable to the Schenectady Photographic Society and this completed form to: Pat McCormick, SPS Treasurer, 930 Delamont Ave., Schenectady, NY 12307If paying by cash, please print out the completed form and bring with you to the next meeting and present to the treasurer.You will redirected to Paypal.com. Note that you do not need a Paypal account to use this payment method. Click on the "Pay with Debit or Credit Card" link at bottom of the Paypal login screen and you can pay using any credit or debit card without signing into Paypal.Liability Waiver and COVID Safety Requirements AgreementIn consideration of participating in Schenectady Photographic Society in-person events, including meetings, field trips and banquets, I hereby agree to release and hold harmless the Schenectady Photographic Society and its officers, directors, employees, representatives, agents, and volunteers (collectively, the “Releasees”), from any and all liability and responsibility whatsoever, for any and all damages, claims, or causes of action that I may have for any loss, illness, personal injury, death, or property damage arising out of, connected with, or in any manner pertaining to Schenectady Photographic Society in-person events, whether caused by the negligence of Releasees or otherwise.This release shall be binding upon me and my estate, heirs, administrators, executors, and assigns.I fully understand that there are potential risks and hazards associated with Schenectady Photographic Society in-person events and their potential related travel, including, but not limited to, possible injury or loss of life. I further understand that while at Schenectady Photographic Society in-person events, I may be visiting locations and interacting with persons that are not associated with or under the control or supervision of the Releasees. Despite the potential risks and hazards , I wish to proceed, and freely accept and assume all risks and hazards that may arise and that could result in loss, illness, personal injury, death, or property damage, whether caused by the negligence of Releasees or otherwise.I further hereby agree to indemnify and hold harmless the Releasees from any judgment, settlement, loss, liability, damage, or costs, including court costs and attorney fees for both the trial and appellate levels that Releasees may incur as a proximate result of any negligent or deliberate act or omission on my part during my participation in the Schenectady Photographic Society in-person events.Keeping safety in mind, it is highly recommended that all attendees at in-person events, such as meetings, field trips and banquets, be up to date with vaccinations against COVID 19. If anyone has any new or worsening symptoms that may be COVID related, a negative COVID test is required no more than 24hrs prior to attending an in-person event.Acknowledgment:I acknowledge and represent that I have read and understand this Liability Waiver and COVID Safety Requirements Agreement and that I agree to it voluntarily and for full and adequate consideration, fully intending to be bound by the same.Vaccination Status*I have been fully vaccinated against COVID 19. Yes NoAcknowledgement* I acknowledge and represent that I have read and understand it and that I agree to it voluntarily and for full and adequate consideration, fully intending to be bound by the same.As a member of Schenectady Photographic Society images that you submit to competitions may be used by the club for promotional purposes including display on the SPS Website, Facebook Page and the FOCUS newsletter. Image makers retain all ownership and copyrights.Human VerificationCommentsThis field is for validation purposes and should be left unchanged.