Greater Johnstown Athletic Ski Club
P.O. BOX 937 JOHNSTOWN, PA 15907
___ New Member ___ Renewal
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or mail):
______ E-mail address________________________________________________________________
_______ US Mail
NAME______________________________________________________________________________________________________
ADDRESS_____________________________________________
CITY_______________________ STATE_____ ZIP___________
PHONE (________) ____________________ Cell Phone: ( ) ___________________ Work Phone optional (_______)___________________
Check all that apply.
SKI
INTEREST: ____ Downhill ___ Cross Country
OTHER INTERESTS: ____ Bicycling ___Golf ___ Hiking ___Bowling ___ Motorcycling
___ Mt. Biking ___WW Rafting ___Canoeing ___ Trips ____________
Location
_____ Other
_________________________
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I, the above named individual, being 21 years of age or older, in consideration of services which have been or will be performed by the Greater Johnstown Athletic Ski Club, in providing travel arrangements and activities, and of being permitted to participate in the club trips, activities, events and other functions which I recognize as being hazardous, do for myself, my personal representatives and next of kin:
(1) hereby release, waive,
discharge and covenant not to sue or hold liable the Greater Johnstown Athletic
Ski Club, it’s officers, directors and trustees, all for the purposes herein
referred to as Releases, from all loss or damage, and any claims or demands,
therefore, on account of injury to the person or property, or resulting in
death, whether cause by the negligence of Releases, or otherwise while for any
purpose participating in any event or activity: and (2) hereby agree to
indemnity and save and hold harmless the Releases from any loss, liability,
damage, or cost they may incur due to my presence and or participation during
any activity and whether caused by the negligence of the Releases or otherwise;
and (3) hereby assume full responsibility for any risk of bodily damage,
death or property damage due to negligence of Releases or otherwise while
traveling, participating or for any other purpose while engaged in such
activities. I expressly agree that the
foregoing Release, Waiver and Indemnity Agreement is intended to be as bored
and inclusive as is permitted by the laws of the state, states and counties in
which the activity is conducted and that if any person thereof is held invalid,
it is agreed that the balance of the agreement shall continue in full legal
force and effect.
I have read and voluntarily signed the Release and Waiver of Liability and Indemnity Agreement which shall remain in full legal force and effect until such time I notify the Greater Johnstown Athletic Ski Club in writing that this agreement is voided.
Signature___________________________________________________ Date_________________________
(Only
ONE signature per application)
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THIS LINE
Membership Fee - $25.00 Check #_____________ Date Received_________ New Card #_______________
Cash ______________ Date Received
_________ Communications
________________ Secretary ________________
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