Membership
Application Kronenstadt Ski Club
General Release, Assumption of Risk and Indemnity Agreement
RELEASE AND WAIVER OF
LIABILITY:
In consideration for being accepted or continuing as a member of
Kronenstadt ski Club, the undersigned, for himself or herself and personal
representatives, assigns, heirs, next of kin, or either of them:
HEREBY RELEASES, WAIVES, DISCHARGES AND COVENANTS not to sue the
Kronenstadt Ski Club (“CLUB” hereafter), its officers and members, for all
purposes herein referred to as ‘Releasees’, from all
liabilities to the undersigned, his or her personal representatives, assigns,
heirs, next of kin for all loss or damage and any claim or demands therefore on
account of injury to the person or property or resulting death of the undersigned,
WHETHER caused by negligence or the Releasees or
otherwise while the undersigned is participating in ANY activity of the club.
The undersigned expressly agrees that the foregoing RELEASE AND
WAIVER OF LIABILITY is intended to be as broad and inclusive as is permitted by
the laws of the State of
ASSUMPTION OF RISK:
The undersigned
hereby warrants that he or she is fully aware of the risks and hazards inherent
in participating in the activities of the Club and hereby voluntarily elects to
participate. The undersigned hereby voluntarily assumes all risk of loss,
damage or injury that may be sustained by him or her and any damage to property
of the undersigned in the activities of the Club.
INDEMNITY AGREEMENT:
The undersigned hereby agrees to indemnify and save and hold
harmless the Releasees and each of them from any
loss, liability, or damage they may incur due to the presence, or any action
of, the undersigned in the, whether caused by the Releasees
or otherwise.
The undersigned has read and voluntarily signs this RELEASE
AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT. The
undersigned understands that this is intended to be all encompassing, from the
date hereof continuing in effect, and in addition to and not limiting any
further or later release signed by the undersigned.
I HAVE READ THE BY-LAWS OF KRONENSTADT SKI CLUB AND AGREE TO ABIDE
BY THE BY-LAWS AND RULES OF THE CLUB.
Dated
this ______ date of ________________, 20____. ____________________________________ (Signature)
In applying for membership
in the Kronenstadt Ski Club and signing the above waiver, I submit the
appropriate membership dues (see below) for the coming 2009-2010 membership year, and furnish the following information for your
records: (Please Print)
Check: Renewing 2008-2009
Member ( ) New Member ( )
Renewing Member from previous year (
)
Phone: Home (_______)__________________________________ Work (______) ____________________________
Cell (_______)___________________________________ Fax
(_______) ____________________________
Email __________________________________________________________________________________________
Birth Date (Month / Day) _____________________Ski Ability Beginner ( ) Intermediate ( ) Advanced ( )
Single ( ) / Married ( ) Spouse: ___________________ Home Available for Kronie Event Yes
( ) No ( )
Return this completed form.
KRONENSTADT
SKI CLUB
SPORT
PARTICIPANT RELEASE OF LIABILITY, WAIVER OF CLAIMS, EXPRESS ASSUMPTION OF RISK
AND INDEMNITY AGREEMENT.
Please read and be certain you
understand the implications of signing.
Express Assumption of Risk Associated
with Sport, Venue Use and Related Activities.
I,
_________________________________________do hereby affirm and acknowledge that
I have been fully informed of the inherent hazards and risks associated with
skiing, snowboarding or other KSC activities, transportation
of equipment related to the activities, and traveling to and from activity
sites in which I am about to engage. Inherent hazards and risks include but
are not limited to:
1.
Risk
of injury from the activity and equipment utilized is significant including the
potential for broken bones, severe injuries to the head, neck, and back or
other bodily injuries that my result in permanent disability and death.
2.
Possible
equipment failure and/or malfunction or misuse of my own or others’ equipment.
3.
I
AGREE THAT I WILL WEAR APPROVED PROTECTIVE GEAR AS DECREED BY THE GOVERNING
BODY OF THE SPORT I AM PARTICIPATING IN. However, protective gear cannot
guarantee the participant’s safety. I further agree that no helmet can protect
the wearer against all potential head injuries or prevent injury to the
wearer’s face, neck or spinal cord.
4.
Variation
and/or steepness of terrain, variation or changes in surfaces including but not
limited to snow surfaces, ice, bare spots, rocks, stumps, debris, cliffs,
trees, fences, posts, trees, light poles, signs, buildings, roads, walkways,
ramps, rails, stairs, pyramids, manual pads, bowls, halfpipes,
jumps, padded and non-padded barriers, other persons, and other natural and
man-made hazards.
5.
My
own negligence and/or the negligence of others, including but not limited to
operator error and guide decision making including misjudging terrain, weather,
riding surfaces or other obstacles.
6.
Exposure
to the elements and temperature extremes may result if frost nip, frost bite,
heat exhaustion, heat stroke, sunburn, hypothermia and dehydration.
7.
Dangers
associated with exposure to natural elements include but are not limited to
avalanche, rock fall, inclement weather, thunder and lighting, severe and or
varied wind, temperature and other weather conditions.
8.
Accidents
or illness occurring in remote places where there are no available medical
facilities.
9.
Fatigue,
exhaustion, chill, and/or dizziness, which may diminish my/our reaction time
and increase the risk of accident.
10.
Impact
or collision with other athletes, spectators, facility employees, pedestrians,
motor vehicles, and cyclists.
*I understand the description of
these risks is not complete and unknown or unanticipated risks may result in
injury, illness, or death.
Release of Liability, Waiver of
Claims and Indemnity Agreement
In consideration for being permitted
to participate in the above described activity(ies) and related activities, I hereby agree,
acknowledge and appreciate that:
1.
I HEREBY RELEASE AND HOLD HARMLESS WITH RESPECT TO ANY AND ALL INJURY,
DISABILITY, DEATH, or
loss or damage to person or property, WHETHER CAUSED BY NEGLIGENCE OR
OTHERWISE, the following named persons or entities, herein referred to as releasees.
Kronenstadt Ski Club,
2.
To
release the releasees, their officers, directors,
employees, representatives, agents, and volunteers from liability and
responsibility whatsoever and for any claims or causes of action that I, my
estate, heirs, survivors, executors, or assigns may have for personal injury,
property damage, or wrongful death arising from the above activities whether
caused by active or passive negligence of the releasees
or otherwise. By executing this document, I agree to hold the releasees harmless and indemnify them in conjunction with
any injury, disability, death, or loss or damage to person or property that may
occur as a result of my engaging in the above activities.
3.
By
entering into this Agreement, I am not relying on any oral or written
representation or statements made by the releasees,
other than what is set forth in this Agreement.
4.
This
agreement shall apply to any and all injury, disability, death, or loss or
damage to person or property occurring at any time after the execution of this
agreement.
This release
shall be binding to the fullest extent permitted by law. If any provision of
this release is found to be unenforceable, the remaining terms shall be
enforceable.
I HAVE READ THIS RELEASE OF LIABILITY
AND ASSUMPTION OF RISK AGREEMENT, I FULLY UNDERSTAND ITS TERMS, I UNDERSTAND
THAT I HAVE GIVEN UP LEGAL RIGHTS BY SIGNING IT, AND I SIGN IT FREELY AND
VOLUNTARILY WITHOUT ANY INDUCEMENT. I AM OVER 21 YEARS OF AGE.
S/_________________________ ___________________________ _________________
Signature of Participant Name of Participant
(Please Print) Date
______________________________________________________ ___________________________
Address
Phone
Email
________________________________________________________