Registration
* This Field is required Required field | This Field IS visible on profile Field visible on your profile | This Field IS NOT visible on profile Field not visible on profile | Information for: ? : Field description: Move mouse over icon Information: Point mouse to icon

Please fill in all the required fields and complete the registration process by paying for your Chiltern membership securely online with Paypal.

This Field IS visible on profile

Your image will be resized if needed to a maximum dimension of 200 pixels width x 500 height automatically, but your image file should not exceed 2000 KB.

Select file

By clicking "Register", you certify that you have the right to distribute this photo and that it does not violate the Terms and Conditions.

* This Field is required This Field IS visible on profile Information for: First name : <p>Please enter your real first name.</p>
* This Field is required This Field IS visible on profile Information for: Last Name : Please enter your real last name.
* This Field is required This Field IS NOT visible on profile Information for: Email : Please enter a valid e-mail address. A confirmation email will be sent to this address upon registration.
* This Field is required This Field IS visible on profile Information for: Username : Please enter a valid username.  No spaces, at least 3 characters and contain 0-9,a-z,A-Z
* This Field is required This Field IS NOT visible on profile
This Field IS visible on profile
This Field IS visible on profile
This Field IS visible on profile Information for: Date membership paid (or today's date) : <p>Date of most recent paid membership</p>
This Field IS visible on profile
* This Field is required This Field IS NOT visible on profile Information for: D.O.B. : <p>Chiltern members must 18 years of age or older to join.  At this time minors are not permitted to join.  Children may accomapny their parents on Chiltern events, but Chiltern assumes <strong>NO</strong> responsibility for minors. Format: mm/dd/yyyy</p>
* This Field is required This Field IS NOT visible on profile Information for: Signature : <p>By typing your name here, you agree to the Terms &amp; Conditions of Chiltern's liability waiver:<br /><span style="font-size: small;"><span style="font-size: x-small;"><br />Participants agree to assume all risks associated with their participation in events organized by Chiltern Mountain Club members or publicized in the Chiltern Mountain Club newsletter. Chiltern Mountain Club activity leaders run events on the express condition that Chiltern Mountain Club, its members and leaders shall not be held responsible for any personal injury, damage, loss of property, accident, or loss of any kind, whether alleged to be caused by act or omission.</span></span></p>
* This Field is required This Field IS NOT visible on profile Information for: Password : <p>Enter a unique password only you should know.  Min. 6 characters.  To change your password, type it here and retype it below to confirm, the click Update button below.</p>
* This Field is required This Field IS NOT visible on profile Information for: Verify Password : <p>Enter a unique password only you should know.  Min. 6 characters.  To change your password, type it here and retype it below to confirm, the click Update button below.</p>
This Field IS visible on profile
Image with security code embedded in itclick here to hear the letters
* This Field is required This Field IS NOT visible on profile Information for: Security Code: : Enter Security Code from image. If no image is present then try disabling your advertisement blocker and then refresh this page. Otherwise please contact the website administrator for assistance.
 
Thank you for completing the membership for the Chiltern Mountain Club! Your membership will be approved as soon as possible. For any questions or if there's an unexpected delay, please email membership@chiltern.org. Chiltern is an all-volunter club, and sometimes response time may take a couple days.

* This Field is required Required field | This Field IS visible on profile Field visible on your profile | This Field IS NOT visible on profile Field not visible on profile | Information for: ? : Field description: Move mouse over icon Information: Point mouse to icon