Application Status* New Member Renewal Membership Type* Individual ($35/yr) Family ($45/yr) Student ($20/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 AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest 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. Family Member Name 1 Email (optional) Family Member Name 2 Email (optional) Family Member Name 3 Email (optional) Family Member Name 4 Email (optional) Payment Method* Debit/Credit/Paypal Check Cash If 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 WaiverIn consideration of participating in Schenectady Photographic Society in person events including meetings, field trips and banquets, I hereby agree that for myself, and my estate, heirs, administrators, executors, and assigns, hereby release and hold harmless the Schenectady Photographic Society and their officers, directors, employees, representatives, agents, and volunteers (collectively, the “Releasees”), from any and all liability and responsibility whatsoever, however caused, for any and all damages, claims, or causes of action that I, my estate, heirs, administrators, executors, or assigns 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. 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 the safety of our members in mind, all in person events including meetings, field trips and banquets, will require being fully vaccinated against COVID 19 to attend. If not fully vaccinated against COVID 19 you may only attend Schenectady Photographic Society online events. Vaccination Status*I have been fully vaccinated against COVID 19. Yes No Acknowledgement* 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 submission to Photographic Society of America Interclub competitions. Human VerificationPhoneThis field is for validation purposes and should be left unchanged.