Trip Application
KRONENSTADT SKI CLUB
General Release, Assumption of Risk
and Indemnity Agreement
Trip to:
Mammoth Mountain Date: (circle
one) Dec.11-13, 2009 Jan. 8-10, 2010 Jan. 29-31, 2009
Feb.
19-21, 2010 March 5-7, 2010 March 26-28, 2010
In consideration for being accepted as a trip
participant, 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, 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 OFTHE RELEASEES OR OTHERWISE while the UNDERSIGNED is
participating in the above trip.
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 above
trip and in any event related thereto, including but not limited to, the
sport(s) of alpine skiing, white-water rafting, and/or water skiing, and hereby
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 while participating in the above trip.
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 above trip, whether caused by the RELEASEES or otherwise.
The UNDERSIGNED has read and voluntarily signs
the RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, and INDEMNITY
AGREEMENT.
Dated this ______ day of
___________________, 20_____.
_____________________________________________________
Signature
_____________________________________________________
Amount $__________ Please
Print Name
(_______)
_________________________________________________________________________________________
Phone
Email
Preferred Roommate
Request: _____________________________________________________
If
Desired, Enter Name (Request Cannot Be Guaranteed)
IN CASE OF EMERGENCY,
please notify:
Name:
______________________________________
Phone: __________________________