Central Connecticut Grotto Membership Form

Please choose your membership class. You may change to another class when renewing your membership.

Regular Dues: $5/year, or optionally $20/5 yrs available only to NSS members.
Receives any generally distributed publications. A Regular Member who is also a member of the NSS may hold office and vote. A Regular Member who is not a member of the NSS may vote on matters not affecting the NSS. Same age requirement as an NSS Regular member, currently 17 years and older.
Associate Dues: $2/year.
Receives any generally distributed publications. Non-voting, cannot hold office. Intended for family members, youth members (all under 17 years), and full-time students.
Institutional Dues: None.
Limited to educational, scientific, and conservation organizations. Receives any generally distributed publications.  The Institution cannot hold office, and members of the Institution are not considered CCG members unless they join as a Regular or Associate member.  A designated representative may vote on behalf of the Institution on matters not affecting the NSS. The membership period is one year, which may be renewed at the end of the membership period by letter or email from the organization.

All Grotto communications, such as meeting and trip notices are sent by email. Please list an email address, which will be added to the CCG list service and enables both sending and receiving CCG email. An optional additional email address may also be listed for CCG email. Areas marked with * are required. NSS Membership is not required to join, but is encouraged.  The membership year starts on the first day of the month following dues payment. Dues renewal payments are added to the end of the prior dues period, no matter when paid.

*Membership Class (select one):       Regular         Associate       Institutional

* Name:       NSS Membership Number:
Address:   * Town:
* State:    * Zip:
Phone 1:      Phone 2:
* E-Mail 1:
E-Mail 2:

I acknowledge that caving and related activities are inherently dangerous and by signing below I release the CCG, the NSS, their members, and officers from any liability resulting from CCG or related activities.
* Signature:     * Date: 
* Membership dues:     * Number of years covered by dues:
Optional  donation:      * Total enclosed:

Fill out this form, print out this form, sign and date the form, send cash or make check payable to "Norman Berg" (not to the CCG), and mail with the form to: Norm Berg,  100 Edgewood Circle,   Southington, CT   06489-2166

Telephone contacts:
    Emily Ray:    203-589-2376 (membership)
    Norm Berg:   860-621-2080 (alternate membership contact)
E-Mail: membership@ctcavers.org
Website: http://www.caves.org/grotto/ccg/
rev: 27-December-07