Cuyahoga Valley Scenic Railroad Brakeman

Cuyahoga Valley Scenic Railroad

MEMBERSHIP FORM
Cuyahoga DD Family Supports Program (FSP) Funding
PLEASE READ BEFORE REQUESTING A MEMBERSHIP, AS MEMBERSHIPS CANNOT BE REFUNDED:

Data collection from recent monitoring of the closed area of the track indicates unexpected changes in the land surrounding the rails along the riverbank. The railroad has been advised to forgo future use of the tracks until further testing and analysis was completed.

With this new information, they have suspended all activities from their Spring event calendar, including those held on The Cleveland Dinner & Events Train and the National Park Scenic Excursion.
Individual Receiving FSP funding
First Name of Child/Individual*
Last Name of Child/Individual*
Date of Birth*

MonthDayYear
Date
Date of Birth

YearMonthDay
Date
Are there other individuals in your household receiving FSP services?*

YesNo
Do you want the cost of this membership to be split up amongst multiple individuals receiving FSP services?*

YesNo
Please list all the FSP individuals whose FSP funding is to be used towards this membership, and the amount for each.*
Membership type:*

Brakeman - $125
*Benefits include: Complimentary subscription to the CVSR members-only On Track e-newsletter. | 20% discount on concessions and CVSR merchandise from January-October. Onboard purchases only. Excludes alcohol. | 2 complimentary coach roundtrip tickets per day aboard the National Park Scenic Excursions. Subject to daily availability. | Name recognition in CVSR Annual Report. | Early access to purchase 8 tickets to the North Pole Adventure.
Please choose a membership type:*

Brakeman - $125Stationmaster - $250
Brakeman - $125 Benefits include: Complimentary subscription to the CVSR members-only On Track e-newsletter. | 20% discount on concessions and CVSR merchandise from January-October. Onboard purchases only. Excludes alcohol. | 2 complimentary coach roundtrip tickets per day aboard the National Park Scenic Excursions. Subject to daily availability. | Name recognition in CVSR Annual Report. | Early access to purchase 8 tickets to the North Pole Adventure.

Stationmaster - $250 Benefits include: Complimentary subscription to the CVSR members-only On Track e-newsletter. | 20% discount on concessions and CVSR merchandise from January-October. Onboard purchases only. Excludes alcohol. | 5 complimentary coach roundtrip tickets per day aboard the National Park Scenic Excursions. Subject to daily availability. | Name recognition in CVSR Annual Report. | Early access to purchase 12 tickets to the North Pole Adventure. | 1 Explorer Season Pass for access to Bike, Hike, and Run Aboard. Subject to availability. Excludes Kayak. | Exclusive invitation to Behind-the-Scenes Event at CVSR.
Parent/Guardian*

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E-mail*
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Phone Number*
Address*

Street Address

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CityState / Province

Postal / Zip Code
*

I understand my membership fee cannot be refunded
Signature*

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Submission Date*

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Cuyahoga Valley Scenic Railroad

Cuyahoga DD Family Supports Program (FSP) Funding

Individual Receiving FSP funding