BENSCREEK CANOE CLUB
MEMBERSHIP FORM- 2005
ANNUAL DUES: $12.00
FAMILY/INDIVIDUAL. MAKE CHECKS
PAYABLE TO: BENSCREEK CANOE CLUB. 204 MOSSHAVEN WAY. LIGONIER, PA 15658.
THIS ENTITLES YOU TO ONE YEARS MEMBERSHIP, ALL NEWSLETTERS, AND THE CLUB
ROSTER. YOU MUST BE A MEMBER TO ATTEND
MOST BCC ACTIVITIES.
NAME___________________________ PHONE NO. HOME(___) ___________________
ADDRESS________________________ WORK(___)___________________
_________________________________ INCLUDE MY NAME IN ROSTER____________
ZIP
(YES OR NO)
E-mail_____________________________
Padding Information : List
Yourself and Members of Your Family Below Per Sample:
SAMPLE: JANE DOE K1/4;
02/2; I ; X Include in roster : YES NO
1.____________________________
3.__________________________
2.____________________________
4.__________________________
EXPLANATION OF SAMPLE:
Paddling Interests: Water Difficulty: Other
Interests:
(K1) Kayak-Solo Classes of water (
I ) Impromptu
(01) Canoe-Solo you are
comfortable (R) Racing
(02) Canoe-Tandem paddling on
the (W) Weekday Summer
(C1) Decked Canoe International (C)
Canoe Camping
(C2) Decked Tandem Scale of Difficulty
(X) X-Country Ski
(R) Raft (Flat, 1, 2,
3, 4, 5) (M) Climbing
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MEMBER’S
MUTUAL AGREEMENT FOR PROTECTION FROM LIABILITY
I ___________________________________________________
DESIRING TO JOIN MY FELLOW PADDLERS IN THE BENSCREEK CANOE CLUB (BCC), HEREBY DECLARE THAT I FULLY
UNDERSTAND THE FOLLOWING FACTS OF LIFE ON THE RIVER:
(1)
Canoeing, Kayaking, or Rafting, particularly on whitewater rivers, is inherently hazardous and therein
lies some of its appeal for me.
(2) No one but myself is responsible for
my safety when I choose to challenge my capabilities by running a particular
river.
(3) It is my moral and sporting
“duty” to assist my fellow paddlers to the best of my own
personal skill and ability if they appear to need such assistance-but only so
long as I can do so, and in my own best
judgment, without significant danger to myself. I further understand that does not imply a LEGAL duty for me to
do so, nor for anyone else to render me such assistance.
NOW THEREFORE, INTENDING TO BE LEGALLY BOUND, I HEREBY DO WAIVE, for myself, my heirs and assigns, and
for anyone else whomsoever claiming through me, my right to sue or in any other
way to attempt to hold responsible, BCC, its officers or so called “trip
leaders”, or any of my fellow paddlers, for any mishaps to my person, or my
equipment, other than that which is due to the willful and malicious actions of
the individual whom I claim relief.
This waiver is given in the
interest of permitting the BCC to exist and serve the paddling community, and
to enable myself and my fellow paddlers to feel free to donate their services
to improving the sport and to help in training those less skilled without fear
of liability.
MY WAIVER, THEREFORE, IS GIVEN IN CONSIDERATION FOR SIMILAR WAIVERS TO
BE GRANTED ON MY BEHALF BY ALL MEMBERS OF THIS ORGANIZATION.
SIGNED, This
_____________day of______________________,
20_______.
__________________________________ ___________________________________
Signature
Signature