Greater Johnstown Athletic Ski Club

P.O. BOX 937    JOHNSTOWN, PA  15907

 

2007-2008 Membership Application

Annual Membership Fee $25.00

 

___  New Member       ___ Renewal   

PLEASE PRINT CLEARLY

 

IMPORTANT:  Please choose if you want to receive your newsletter via e-mail or US mail.

√ Check only one (either E-mail 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 _________________________

                                       

Release and Waiver of Liability and Indemnity Agreement to

The Greater Johnstown Athletic Ski Club, Incorporated

 

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)

DO  NOT  WRITE  BELOW  THIS  LINE

Membership Fee - $25.00            Check #_____________                Date Received_________                                      New Card #_______________

                                                       Cash    ______________ Date Received _________                                     Communications ________________                                                                                                                                                                                                                          Secretary             ________________