JAC – JRC Mountain Club - Joint Research Centre

J.A.C. -JRC MOUNTAIN CLUB
T.P. 361 - Joint Research Centre
21020 Ispra (VA) ITALY - http://jac.jrc.it
Stefan Scheer (5683) – President, walking coordinator
Ioannis Andredakis - Vice-President
Vanessa Fourcaudot (6064)-Treasurer
Francesco D’Alberti (5657)
Jean-Michel Terres
Adolf Stips (9876) - Library
Application form to join the J.A.C - JRC Mountain Club: Year 2011
For those having subscribed to another CAI section or to another Alpine club
to be returned to Vanessa FOURCAUDOT (TP 440)
Surname:
Name:
Birth Date: Birth Place: Email address:
Phone Extension: Office Address: TP Home or Mobile Phone Number:
Codice Fiscale Number (New members only):
Interests:
Easy walk Y/N - Difficult walking Y/N - Climbing Y/N - Ski Mountaineering Y/N –
Fitness Training Y/N - Participation in suggesting activities Y/N
2011 JAC - JRC Mountain Club Membership Fee:
Single Member 1 € 35
Couple: € 60
The member fee should be transferred to
UBI Banca Popolare di Bergamo,
Fil. Di Leggiuno (0184)
ABI 05428, CAB 50380, C/C 97368,
IBAN: IT43Q0542850380000000097368
In case you have questions regarding the payment of the member fee, please contact the treasurer, Vanessa
Fourcaudot, #6064.
Important declaration:
I declare that I have paid ……. € for the 2011 enrollment at ……………………………………
I herewith add a copy of my enrollment to this club/association.
This club/association is recognized by CAI.
This club/association provides basic insurance to its members.
Date: ……………………………….
Signature: ……………………………………
1 A reimbursement request of up to € 25 can be asked to the JAC board.

Important condition to accept:
I accept and agree with the JAC – JRC Mountain Club Statute and Internal Rules. In
particular, I accept article 9 of the Internal rule: “The members of the Board and organizers of
activities do not accept civil responsibility for any damage or injury caused to members or their
property during Club activities.”
Date: ……………..
Signature: ……………………………………….
++++++++++++++++++++++++++++++++
Privacy Declaration:
1. Herewith you are informed that the JAC – JRC Mountain Club uses and conserves your data
for statutory purposes only, according to art. 13 D.Lgs. 30/6/2003, no. 196, in particular:
o In order to manage the club’s administration and in accordance with the statute
o In order to keep the list of members updated regularly
o In order to promote activities and events and to inform the members about
these.
2. All data the club possesses will not be kept longer than legally required and not be used for
purposes not mentioned under 1.
3. The collected data will be accessible by JAC board members only and by the internal audit
responsibles. The names of the board members may be used on the club’s web pages and in
the header of the inscription forms.
I have taken note and I agree
Date: …………….
Signature: ……………………………………….