Information about membership -
|
|
- Aldous Nichols
- 5 years ago
- Views:
Transcription
1 MEMBERSHIP INFORMATION 2018 We are excited about ST. CROIX JOAD and the opportunities that will present themselves to youth archers ages ST. CROIX JOAD is one of only a handful USA ARCHERY JOAD clubs in Minnesota. Information about membership - Annual membership is $25 per individual per year and $40 per family. ST. CROIX JOAD s membership renews annually in June. Membership must be current to enroll in training sessions, to participate in club competition or to earn achievement awards. The membership fee is in place to cover operating costs such as our annual USA Archery Club registration fee / web fees / administration costs, targets, etc. The membership amount is subject to change and will be reviewed annually. Members must join USA ARCHERY (mandatory for JOAD membership at national level) and is an annual membership (visit USA ARCHERY Website for registration, cost and details - Archery/Membership/Individual-and-Family.aspx ) Membership is required for tournament competition and access to coach insurance coverage. We also request you join the state archery organization, MAA (Minnesota Archery Alliance (you can visit their website at As a club we will be following national guidelines at USA ARCHERY / NFAA sanctioned tournaments so, club members need to follow some dress codes. USA Archery publishes its dress code online. Members are asked to participate in approx. 2 hours per year Range / Host service hours. This can be a simple as picking up the range after shooting, setting up and taking down targets, painting stands, etc. We want to show our hosting range (club) how much we appreciate them and the facilities they allow us to use. ST. CROIX JOAD is volunteer organization. Coaches and other leadership opportunities are filled by parent volunteers and other friends of ST. CROIX JOAD. All coaches have background checks processed through USA ARCHERY All our coaches have taken SafeSport and current USA Archery certification. We ask all members to sign the Photo Release form. We will be photographing club events, competitions and individual archers for web site, photo albums, possible media / press releases as well as for training purposes. Equipment It is in the best interest of each archer to own their own equipment. ST. CROIX JOAD has a limited number of bows (Recurve and Genesis) for club use. Please contact us prior to registering for a session if you do not own equipment. We ask that each archer comes to shoot prepared with arm guard, hip quiver and finger tab (if necessary). You should have 12 arrows (minimum of 6). Again, if you don t own equipment please talk to us prior to coming out to shoot. Our Host Range ST CROIX JOAD is fortunate to have a relationship with Bald Eagle Sportsmen s Association in Hugo. BESA Archery has provided us with competition mats, built target stands and provided us with a range to shoot in. Please be courteous guests and follow all club rules when visiting BESA.
2 MEMBERSHIP FORM 2018 { Please submit this form and payment along with signed release forms by mail to St. Croix JOAD c/o D Kleinke 116 6TH ST S, Stillwater, MN } ST CROIX JOAD does not guarantee club membership. Applications are reveiwed and accepted based on current numbers and volunteers Membership fee - $25.00 individual / $40.00 family Archer s Name (all if family) : Address: City State Zip Phone: Date of Birth: Competition / Equipment Class: USA Archery Membership Number: Date: You can find USA Archery membership info on their website: Archer s experience level and brief bio: Parent s Name or Legal Guardian: Phone: Cell: Address: Phone: Please Note - we ask that members participate in up to 2 hours of Range / Host service hours. This can be as simple as sweeping up after shooting, setting up or taking down targets, painting stands, etc. We want to be good stewards of the facilites we are fortunate enough to shoot at. All members are required to abide by club rules, safety and range rules. Membership may be revoked at any time without refund for failing to abide by these rules. TO BE FILLED OUT BY ST CROIX JOAD Date Membership Submitted : Membership Card Processed : Paid By : Check # Amount $
3 ST CROIX JOAD A USA Archery Junior Olympic Archery Development Club I hereby grant ST. CROIX JOAD permission to use my likeness in a photograph in any and all of its publications to promote ST. CROIX JOAD and the sport of archery, including website entries, without payment or any other consideration. I understand and agree that these materials will become the property of ST. CROIX JOAD. I hereby irrevocably authorize ST. CROIX JOAD to edit, alter, copy, exhibit, publish or distribute this photo for purposes of publicizing ST. CROIX JOAD s programs or for any other lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph. I hereby hold harmless and release and forever discharge ST. CROIX JOAD from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization. I am 21 years of age and am competent to contract in my own name. I have read this release before signing below and I fully understand the contents, meaning, and impact of this release. (Signature) (Date) (Printed Name) (Date) If the person signing is under age 21, there must be consent by a parent or guardian, as follows: I hereby certify that I am the parent or guardian of, named above, and do hereby give my consent without reservation to the foregoing on behalf of this person. (Parent/Guardian s Signature) (Date) (Parent/Guardian s Printed Name)!!!
4 RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT READ AND UNDERSTAND BEFORE SIGNING In consideration of being allowed to participate in any way in St. Croix JOAD LLC (aka St. Croix JOAD) club events and use of the shooting range ( Activities ), the undersigned acknowledges, appreciates and agrees that: 1) I FULLY UNDERSTAND that: (a) the risk of injury from archery and other known and unknown events and activities and/or the use of the related buildings, structures, equipment, and all other real and personal property whether owned by the archery club or others is significant, including the potential for SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS AND DEATH ( Risks ); (b) these Risks may be caused by my own actions, or inaction s, the actions or inaction s of others participating in the Activity; the condition in which the Activity takes place; or THE NEGLIGENCE OF THE RELEASEES NAMED BELOW; (c) there may be other risks and social and economic losses either known to me, not known to me or not readily foreseeable at this time; and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS AND DAMAGES incurred as a result of my participation in the Activity; and 2) I state that, in my own best judgment, I understand the basic safety principles and practices of shooting archery and have read and understood St. Croix JOAD LLC club s safety rules and practices; and 3) I acknowledge and agree that the use of archery equipment, by myself or others on club premises or otherwise are inherently dangerous and high risk activities whether such archery equipment are discharged by myself or others; and 4) I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF OTHERS, and assume full responsibility for my participation; and 5) I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation; and 6) I, and on behalf of my heirs, assigns, personal representatives and next of kin, HEARBY RELEASE, HOLD HARMLESS AND INDEMNIFY St. Croix JOAD LLC aka St. Croix JOAD, its officers, directors, board members, club members, officials, agents, employees, volunteers, guests, other participants, sponsoring agencies, sponsors, advertisers, and if applicable owners and lessors of real property and personal property used to conduct the events, activities and/or range usage ( RELEASEE ),WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, TO THE FULLEST EXTENT PERMITTED BY LAW. I further agree that if, despite this release, I, or anyone on my behalf makes a claim against any of the Releasees named above, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS EACH OF THE RELEASEES FROM ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS, LIABILITY, DAMAGE OR COST THAT MAY INCUR AS THE RESULT OF ANY SUCH CLAIM; and 7) I agree that the foregoing release, waiver and indemnity agreement is intended to be as broad and inclusive as is permitted by the law of the State of Minnesota and are in effect for any and all events, activities and shooting range usage I participate in or use at St. Croix JOAD LLC club now and in the future and is in force, valid, effective and in effect for the entire time I am a member, guest, or visitor of the St. Croix JOAD LLC club. If any portion of this Release and Waiver of Liability is held invalid, I agree that the remainder shall continue in full force and effect. I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND IT S TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND HAVE SIGNED IT FREELY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY THE LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THAT THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT. Participants Name Participant s Signature Date signed:
5 RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT (MINORS UNDER AGE 18) READ AND UNDERSTAND BEFORE SIGNING In consideration of my minor child being allowed to participate in any way in St. Croix JOAD LLC (aka St. Croix JOAD) club events and use of the shooting range ( Activities ), the undersigned acknowledges, appreciates and agrees that: 1) I FULLY UNDERSTAND that: (a) the risk of injury from archery and other known and unknown events and activities and/or the use of the related buildings, structures, equipment, and all other real and personal property whether owned by the archery club or others is significant, including the potential for SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS AND DEATH ( Risks ); (b) these Risks may be caused by the Minor s own actions, or inaction s, the actions or inaction s of others participating in the Activity; the condition in which the Activity takes place; or THE NEGLIGENCE OF THE RELEASEES NAMED BELOW; (c) there may be other risks and social and economic losses either known to me, not known to me or not readily foreseeable at this time; and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS AND DAMAGES incurred as a result of the Minor s participation in the Activity; and 2) I state that, in my own best judgment, I understand the basic safety principles and practices of shooting archery and have read and understood St. Croix JOAD LLC club s safety rules and practices; and 3) I acknowledge and agree that the use of archery equipment, by myself or others on club premises or otherwise are inherently dangerous and high risk activities whether such archery equipment are discharged by myself or others; and 4) I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF OTHERS, and assume full responsibility for my participation; and 5) I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation; and 6) I, and on behalf of my heirs, assigns, personal representatives and next of kin, HEARBY RELEASE, HOLD HARMLESS AND INDEMNIFY St. Croix JOAD LLC aka St. Croix JOAD, its officers, directors, board members, club members, officials, agents, employees, volunteers, guests, other participants, sponsoring agencies, sponsors, advertisers, and if applicable owners and lessors of real property and personal property used to conduct the events, activities and/or range usage ( RELEASEE ),WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, TO THE FULLEST EXTENT PERMITTED BY LAW. I further agree that if, despite this release, I, the minor, or anyone on the Minor s behalf makes a claim against any of the Releases named, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS EACH OF THE RELEASEES FROM ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS, LIABILITY, DAMAGE OR COST ANY MAY INCUR AS THE RESULT OF ANY SUCH CLAIM; and 7) I agree that the foregoing release, waiver and indemnity agreement is intended to be as broad and inclusive as is permitted by the law of the State of Minnesota and are in effect for any and all events, activities and shooting range usage the Minor participate in or use at St. Croix JOAD LLC club now and in the future and is in force, valid, effective and in effect for the entire time the Minor is a member, guest, or visitor of the St. Croix JOAD LLC club. If any portion of this Release and Waiver of Liability is held invalid, I agree that the remainder shall continue in full force and effect. I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND IT S TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND HAVE SIGNED IT FREELY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY THE LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THAT THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT. Name of Minor Child (Please Print) Printed Name of Parent or Legal Guardian Emergency Phone Number: ( ) Signature of Parent or Legal Guardian Date signed:
Release of Liability PLEASE DO NOT CHANGE OR ALTER THE WORDING ON THIS WAIVER WITHOUT PRIOR APPROVAL FROM USROWING.
Release of Liability IN CONSIDERATION of being given the opportunity to participate in any USRowing activity, including scheduled, supervised club activities, and registered regattas, during the policy
More informationLake Washington Rowing Club
Lake Washington Rowing Club 2018 Junior Rowing Program Participant Information Form Participant Information (all fields must be filled out),, Last Name First Name Today s Date Mailing Address Birthdate
More informationThe 2018 Rhode Island NFAA Sanctioned 300 Round NFAA State Championship
The Rhode Island Field Archery Association is proud to present : The 2018 Rhode Island NFAA Sanctioned 300 Round NFAA State Championship Hosted By: Tangy s Archery --Youth Form-- Style Division Target
More informationThe 2017 Rhode Island NFAA Sanctioned 300 Round NFAA State Championship
The Rhode Island Field Archery Association is proud to present : The 2017 Rhode Island NFAA Sanctioned 300 Round NFAA State Championship Hosted By: Trader Jan s --Youth Form-- Style Division Target Choice
More informationParticipant Information (Incomplete information will not be processed) Last Name First Name Male Female Date of Birth: / /
2018 Denver NorthSide TTC FALL CLASSIC TOURNAMENT ENTRY FORM Sponsored by Denver Northside Table Tennis 1-Star Tournament Sanctioned by USATT with $500.00 in Cash and Trophies Saturday, October 13 th,
More informationMEMBERSHIP CATEGORY (circle one) For current dues please refer to the website Membership page
Page 1 MEMBERSHIP REGISTRATION RAT ISLAND ROWING AND SCULLING CLUB NAME (print clearly): Date of birth: / / Home phone: ( ) - - Work/Cell: ( ) - - Email: Mailing address (city/ state) (Zip) Today s date:
More informationUpper Natoma Rowing Club Junior Member Application (Please print clearly)
Upper Natoma Rowing Club Junior Member Application (Please print clearly) Name Birth Date Address City State Zip Code Phone Numbers (Home) Athlete (Cell) Athlete E-mail address School Graduation Year USRA
More informationADULT COACHING APPLICATION
- MIAMI ROWING & WATERSPORTS CENTER, Inc. ADULT COACHING APPLICATION -MEMBER HRLY Private lessons where non-members and members can come and row in a one-on-one session tailored to your skill level and
More informationParticipant Information (Incomplete information will not be processed) Last Name First Name Male Female Date of Birth: / /
ENTRY FORM Sponsored by Denver Northside Table Tennis 1-Star Tournament Sanctioned by USATT with $ 300 in Cash and Prizes Saturday, March 24 th 2018 www.denvernorthsidett.com or 303-601-3415 Participant
More information2015 AAU/USA NATIONAL KARATE CHAMPIONSHIPS
2015 AAU/USA NATIONAL KARATE CHAMPIONSHIPS CLUB APPLICATION INSTRUCTIONS 1. Any AAU member club may send in a club application, instead of individual entry applications. 2. Please follow all instructions
More information2016 AAU/USA NATIONAL KARATE CHAMPIONSHIPS CLUB APPLICATION INSTRUCTIONS
2016 AAU/USA NATIONAL KARATE CHAMPIONSHIPS CLUB APPLICATION INSTRUCTIONS 1. Any AAU member club may send in a club application, instead of individual entry applications. 2. Please follow all instructions
More informationPlease note that there is no liability coverage for wrestling activities held at a home or residential dwelling
Insurance coverage 2017-18 Insurance Information At USA Wrestling, our top priorities are safety and security. That's why we make sure you're covered by General Liability, Accidental Medical Expense, and
More informationPOTOMAC VALLEY AAU REGISTRATION INFORMATION
POTOMAC VALLEY AAU REGISTRATION INFORMATION Please ensure ALL documents are completed as indicated and placed in a large 9x12 envelope. Note: Rules requiring Government issued ID are in effect. Do not
More informationInstructions for Completing Ford DSFL Waivers
Instructions for Completing Ford DSFL Waivers 1) Print out the four (4) forms attached. (Print in color if possible) 2) All 4 forms must be filled in COMPLETELY. If forms are not completed and signed properly
More informationRegistration Form. Mother s/guardian Name: LAST FIRST INITIAL Address: Home Phone: City: State: Zip: Cell Phone:
Registration Form Name: Address: City: State: Zip: School: Grade: Grad Year: GPA: HT: WT: Cell Phone: Email: Size: Shirt: Pants: Helmet: Shoe: Jersey #: (List 3 numbers) Parent/Guardian Information Player
More informationSCCA Rally/Solo Release and Waiver Guidelines
RISK MANAGEMENT I. Introduction SCCA Rally/Solo Release and Waiver Guidelines These guidelines are intended to provide basic information regarding release and waiver procedures for ALL non-club or SCCA
More informationPocock Rowing Center
Pocock Rowing Center Office Use QB LGL XL S Code Membership Forms New Member Existing Member Former Member First Name: Last Name: Address: City: St: Zip: Email Address: Cell Phone ( ) Alt Phone: ( ) Gender:
More information2016 5K Reindeer Run/Walk Team Registration
2016 5K Reindeer Run/Walk Team Registration Team Registration Forms and Waiver must be fully completed and received by December 2 nd in order to receive the $20/person group rate; Minimum of 3 people per
More informationPARTICIPANT AGREEMENT (For Adult Participants) RELEASE OF LIABILITY, VOLUNTARY ASSUMPTION OF RISK AND INDEMNITY AGREEMENT
EXHIBIT D PLEASE READ CAREFULLY (For Adult Participants) RELEASE OF LIABILITY, VOLUNTARY ASSUMPTION OF RISK AND INDEMNITY AGREEMENT I,, a person being over the age of eighteen, hereby enter this RELEASE
More informationNSU PREVIEW DAY. Wednesday, March 28, :00 a.m. 6:00 p.m.
PREVIEW DAY NSU Multimedia Camp Wednesday, March 28, 2018 8:00 a.m. 6:00 p.m. Parent/Guardian Contact Information Release and Waiver of Liability, Assumption of Risk and Indemnity Agreement Photo Release
More information2003 AAU JUNIOR OLYMPIC GAMES DanceSport and Salsa ENTRY INSTRUCTIONS
2003 AAU JUNIOR OLYMPIC GAMES DanceSport and Salsa INDIVIDUAL ATHLETE ENTRY FORM ENTRY INSTRUCTIONS ENTRY DEADLINE: Received by Tuesday, July 1, 2003. Late entries will not be accepted. Guaranteed overnight
More informationASSANTE DIRTY DASH FOR REBOUND - 5K MUD RUN RELEASE OF LIABILITY, WAIVER OF CLAIMS AND ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT
ASSANTE DIRTY DASH FOR REBOUND - 5K MUD RUN RELEASE OF LIABILITY, WAIVER OF CLAIMS AND ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT Participant s Name: Age: Date of Birth : (M) (D) (Y) Address: City: Province:
More informationMIAMI ROWING & WATERSPORTS CENTER, INC Membership (6 pages) Application For:
MIAMI ROWING & WATERSPORTS CENTER, INC. 2017 Membership (6 pages) Application For: FAMILY MEMBERSHIP: Initiation Fee: $500.00 Monthly Dues: $110.00 Annual Due $1320.00 Equipment Fund Monthly Due $15.00
More informationMembership Registration Form
Today s Date: Leeward Judo Club Membership Registration Form Primary Dojo Location (Check box): Pearl City Waipahu Student Information: Name (First, MI, Last) Date of Birth Age Sex Male Female Address
More information2017 Haunted Halloween Race
2017 Haunted Halloween Race October 28, 2017 5:30pm 7:00pm (1.5 hour meet at regular speed session time) Hosted by: Core Speedskaters INFORMATION You must be a member of Northern California Speedskating
More informationCITY KIDS DAY CAMP REGISTRATION FORM
RETURN CAMP ENTRY FORM WITH PAYMENT TO: M.C. PARKS 100 E. MICHIGAN BLVD. SUITE 2 MICHIGAN CITY, IN 46360 (219) 873-1506 www.michigancityparks.com CITY KIDS DAY CAMP REGISTRATION FORM 1. HOUSEHOLD INFORMATION
More informationUNITED STATES AUTO CLUB
UNITED STATES AUTO CLUB 2015.25 MIDGET FAMILY COMPETITION LICENSE APPLICATION FOR ANNUAL FAMILY MEMBERSHIP & AUTHORIZATION FOR PUBLICITY USEAGE ANNUAL RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK
More informationCAPITAL BADMINTON ACADEMY.
CAPITAL BADMINTON ACADEMY www.capitalbadmintonacademy.com ABOUT US Welcome to Capital Badminton Academy! We re a badminton academy based in DMV (DC, Maryland and Virginia) and we train domestic and regional
More informationSouth Suburban Youth Rugby Club
South Suburban Youth Rugby Club Middle School Grades 4-8 High School Fresh-Soph & Varsity Registration for 2016 Spring Season ALL FORMS MUST BE COMPLETED AND TURNED IN AND DUES PAID IN FULL BEFORE A PLAYER
More informationD.M.G. Athletics. The Official Indoor/Outdoor Summer Basketball League. Team Registration Packet
D.M.G. Athletics Presents The Official Indoor/Outdoor Summer Basketball League Team Registration Packet Questions: Contact Coach Dawne Gittens at 860-929-7692 or via email at dgittens@bgchartford.org Team
More informationKaren McCallum. Volunteer- Counselor in Training Applications. Spring Dear Counselor in Training Applicant:
Volunteer- Counselor in Training Applications Spring 2018 Dear Counselor in Training Applicant: Boardman Park Adventure Day Camp Program prides itself on its reputation for quality and service. This recognition
More informationIndividual waiver Form: Master form included, makes copies as needed. Athletes should sign only where indicated (at ATHELTE S SIGNATURE line).
POTOMAC VALLEY REGISTRATION CHECK LIST Please double check to make certain that the following documents have been completed as indicated: Rules requiring Government issued ID is in effect. Registration
More informationWelcome Team Advisors and Coaches;
Welcome Team Advisors and Coaches; We the Directors of the Texas High School Bass Association want to welcome you to the THSBA! Many of you have watched the growth of our organization over the last four
More information*** ALL handlers/riders/drivers MUST complete this form *** CONDITIONS OF ENTRY AHSA LIABILITY DECLARATION EVERY HANDLER, RIDER, DRIVER, GROOM & ANYONE HANDLING A HORSE OR PONY MUST COMPLETE THE ARABIAN
More information2012 LWRC Dues and Storage Fees
2012 LWRC Dues and Storage Fees Annual Membership Dues Regular Membership - $710.00 ($648.40 plus 9.5% tax) Family Membership $1065.00 ($972.60 plus 9.5% tax) Staff Membership for coaches & coxswains.
More informationUNITED STATES AUTO CLUB
UNITED STATES AUTO CLUB 2016.25 MIDGET FAMILY COMPETITION LICENSE APPLICATION FOR ANNUAL FAMILY MEMBERSHIP & AUTHORIZATION FOR PUBLICITY USEAGE ANNUAL RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK
More informationORDER SONS OF ITALY IN AMERICA LODGE 2662 ARTS & CRAFTS VENDOR CONTRACT/RELEASE
ORDER SONS OF ITALY IN AMERICA LODGE 2662 ARTS & CRAFTS VENDOR CONTRACT/RELEASE DATE: JUNE 22 & 23, 2019 OCTOBER 5 & 6, 2019 LOCATION: THE MARKET COMMONS TIME: JUNE SATURDAY 11 AM 8 PM / SUNDAY 11 PM 7
More informationSchedule: When: Saturday, December Time: 9:00-4:00pm Where: Garrett s Sports Complex/Fieldhouse Cost: $60/ per athlete
When: Saturday, December 9. 2017 Time: 9:00-4:00pm Where: Garrett s Sports Complex/Fieldhouse Cost: $60/ per athlete Instructors: SU Coaches & current SU Athletes Schedule: 9:00-9:45 Registration 9:45
More informationMetzlers Gymnastics Training Center NON-COMPETE TEAM REGISTRATION FORM Please Print Clearly
Metzlers Gymnastics Training Center NON-COMPETE TEAM REGISTRATION FORM Please Print Clearly Last Name: Parent s Name: Address: City: State: Zip Code: Home Phone: Cell Phone: E-mail address: Work Phone:
More informationMembership Application
Membership Application 2018 2019 PLEASE USE A SEPARATE FORM FOR EACH MEMBER All fields must be completed and all required signatures must be included before application will be processed All fields must
More informationWAIVER, RELEASE OF ALL LIABILITY AND ASSIGNMENT OF CLAIMS. As consideration for being allowed to participate in the event described below, I agree:
WAIVER, RELEASE OF ALL LIABILITY AND ASSIGNMENT OF CLAIMS As consideration for being allowed to participate in the event described below, I agree: 1. I acknowledge that motor vehicle activity is a potentially
More informationPage 1 MEMBERSHIP REGISTRATION RAT ISLAND ROWING AND SCULLING CLUB
Page 1 MEMBERSHIP REGISTRATION RAT ISLAND ROWING AND SCULLING CLUB NAME (print clearly): Date of birth: / / Home phone: ( ) - - Work/Cell: ( ) - - Email: Mailing address (city/state) (Zip) Today s date:
More informationSt. Cloud Steelhead Rugby Club Registration Check List 2011 (SCRF01)
St. Cloud Steelhead Rugby Club Registration Check List 2011 (SCRF01) Please make checks payable to St. Cloud Rugby Steelhead Player Full Name: Shorts Size needed (circle one, shorts are men s sizes): Small
More informationCITY OF PALM COAST YOUTH PARKS & RECREATION DEPARTMENT ADULT REGISTRATION FORM SENIOR
CITY OF PALM COAST YOUTH PARKS & RECREATION DEPARTMENT ADULT REGISTRATION FORM SENIOR Please print clearly. Completion of the registration process is required for each participant prior to program start
More informationFlorida Waiver (Commercial) (All parents of minors who are Florida residents must sign both the Florida commercial and non-commercial waivers)
Florida Waiver (Commercial) (All parents of minors who are Florida residents must sign both the Florida commercial and non-commercial waivers) (Commercial Activity Providers) WAIVER AND RELEASE OF LIABILITY
More informationTHE KANSAS INDOOR ROWING CHAMPIONSHIPS XXIX
THE KANSAS INDOOR ROWING CHAMPIONSHIPS XXIX Saturday February 26, 2011 Lyman Elementary School 2032 N. Kansas Ave. Topeka, Kansas 9:00AM to Noon! All races are Finals (with Flights as needed) Events for
More informationU.S. GOLD GYMNASTICS & CHEER ACADEMY INC.
RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT ( AGREEMENT ) In consideration of participating in all activities at U.S. Gold Gymnastics and Cheer Academy, Inc., I represent
More informationNew Member Renewing Member Transferring previous club name
Membership Application 2017-2018 PLEASE USE A SEPARATE FORM FOR EACH MEMBER. Applications are due back in the office when you sign up for ice. *An asterisk indicates a field that is required in order to
More informationPromoters hosting USECF insured events must complete the included USECF event agreement and return to the USECF.
Dear Race Director, Thank you for your interest in using the USECF event coverage for your event. Enclosed you will find USECF insurance information for the 2017 year which can be used for gravel grinders,
More informationMiami Beach Rowing Club 2016 Summer Camp
Miami Beach Rowing Club s Head Coach Vladimir Matovic and his experienced staff are ready to challenge new and experienced rowers to reach their potential in both sweep and sculling. MBRC s rowing camp
More informationDance-Dance/Drill Team
Dance-Dance/Drill Team Photocopy form as necessary. The signed Athlete Waiver must be submitted with this form. INSTRUCTIONS ENTRY DEADLINE: SEND: Received by Tuesday, July 1, 2003. Late entries will not
More information*AHSEP reserves the right, at its sole discretion, to reject any candidate who does not meet the eligibility requirements as stated herein.
AHSEP Enrollment Information Hobie Wave 14 Sailing Classes Youth: Thursdays July 27 & August 3 5:30 8:30 Adults: Saturdays July 29 & August 12 1:30-4:30 The 2017 Hobie Wave 14 Sailing Classes will be a
More informationGet!a!Grip:!Fall!2018! Information*and*Form*Package*
GetaGrip:Fall2018 Information*and*Form*Package* Pleasereturnthefollowingdocumentscompletedto: 1.Email:info@elevationoutdoors.ca OR 2.Mail:P.O.Box20071,TowneCentre,Kelowna,BC,V1Y9H2 ElevationOutdoorsWaiver
More informationEWAUNA ROWING CLUB, INC
EWAUNA ROWING CLUB, INC MEMBERSHIP INFORMATION/INSTRUCTION FORM CLUB DUES/PAYMENT SCHEDULE: Annual dues are effective for the calendar year (January 1 st through December 31 st). A single payment in the
More informationHoover High School Invitational Regatta Hoover Reservoir Westerville, Ohio Saturday, April 12, 2003 Hosted by Westerville Crew
Hoover High School Invitational Regatta Hoover Reservoir Westerville, Ohio Saturday, April 12, 2003 Hosted by Westerville Crew COURSE The racecourse is a 1500-meter course on Hoover Reservoir in Westerville,
More informationAMERICAN YOUTH FOOTBALL Volunteer Forms
Volunteer Forms REQUIRED FOR REGIONAL AND NATIONAL PARTICIPATION Volunteer forms must be presented for compliance verification prior to any team participation in any American Youth Football, Inc., American
More informationOgden Cycle Association Membership Agreement
Date: Ogden Cycle Association Membership Agreement Membership Type: (mark all that apply) Single Family Non-Wor king Charter Life Cash / Check # Amount Paid $ Receipt # New Member / Annual Renewal I agree
More informationCamper Information Camper Name: Age: DOB: Address: City: State: Zip: Parent Information Parent/Guardian Name: Home Phone: Cell: Parent s
9744 St. Vincent Ave. Shreveport, La. 71106 Summer Day Camp 2018 Registration Packet We are delighted you have chosen to consider our fun camps this summer! We are looking forward to another great and
More informationA.A.U. Region 9 Taekwondo Championship March 2, 2013 Butler Sports Complex South Main Houston, Texas INFORMATION SHEET
INFORMATION SHEET Competition Date: SATURDAY, MARCH 2, 2013 Entry Fees: 1 or 2 Individual Events $85.00 3 Events $100.00 CLINICS: Referee Clinic ONLY: $35.00 (coaches must take clinic online!) Friday,
More informationAthletics Participation and Pre-Participation Head Injury/Concussion Reporting Form
Athletics Participation and Pre-Participation Head Injury/Concussion Reporting Form Fall Athletics, 2018 The Parent(s)/Guardian(s) must fill in all blanks. Please print clearly. Athlete s Name: Date of
More informationO*H*I*O MASTERS SWIM CLUB (Old Hearts Inspiring Others) CLEVELAND - WEST SIDE Swim Workouts WINTER, 2017
O*H*I*O MASTERS SWIM CLUB (Old Hearts Inspiring Others) CLEVELAND - WEST SIDE Swim Workouts WINTER, 2017 COACHED WORKOUTS for WINTER 2017 - We offer workouts overseen by experienced coaches. All adult
More information(Student Last name, First name Middle Initial).
2013-14 (Student Last name, First name Middle Initial). Consent for Field Trip (P1a) DHS Band Combined Form P1a, P1b, P1c I hereby consent for the above named student to participate in athletic team, band,
More informationCAMP/CLINIC DATES: July 21 22, 2018 and/or August 11 12, 2018 MEDICAL HISTORY. Street City State Zip
Please fill out this form completely. It is important for the provision of proper medical care. The section marked Physician s Comments need only be completed if the participant has a major health problem.
More informationAthlete C hecklist. Step 1: Step 2: Step 3: Step 4: CONTACT INFORMATION:
Athlete C hecklist Step 1: Complete the ATHLETE REGISTRATION forms including: ATHLETE INFORMATION ATHLETE RELEASE & WAIVER OF LIABILITY & ACCIDENT AGREEMENT PAYMENT AGREEMENT Step 2: Return forms with
More information2012 AAU SOUTHWEST DISTRICT QUALIFIER
INFORMATION SHEET Competition Date: SATURDAY, FEBRUARY 11, 2012 Entry Fees: 1 or 2 Individual Events $65.00 3 Events $75.00 CLINICS: Referee Clinic ONLY: $35.00 (coaches must take clinic online!) Friday,
More informationESO GIRLS FASTPITCH SOFTBALL 2017 PLAYER REGISTRATION
ESO GIRLS FASTPITCH SOFTBALL 2017 PLAYER REGISTRATION Player Information First Name: Last Name: Address: City, State, Zip: Home Phone: Email: Date Of Birth: School: Grade: Jersey Size: Age Division Select
More informationCheer Tumbling Registration Form. (Please complete all fields and understand all information stated below) Student Information
Signature of Parent/or Legal Guardian Cheer Tumbling Registration Form (Please complete all fields and understand all information stated below) How did you hear about us? Referral Name: Student Information
More information2018 Jr. Celtics School Vacation Week Two Day Clinic Registration Packet
2018 Jr. Celtics School Vacation Week Two Day Clinic Registration Packet For more information call 617-399-8432 or email Sam at: jrceltics@celtics.com When: Monday, February 19, 2018 & Tuesday, February
More informationRETAIN THIS SHEET FOR YOUR INFORMATION AND MAIL ENTRY FORM
REVISED 01/20/08 SIXTH ANNUAL AAU TRIPLE CROWN CLASSIC 2008AAU EAST COAST BENCH PRESS CLASSIC 2008 AAU MILITARY NATIONALS FULL POWER 2008 AAU MILITARY NATIONALS BENCH PRESS ENTRY DEADLINE: APRIL 20, 2008
More informationB.A.M. Brevard Attitude Modification
PLEASE PRINT Minor s Name: Age: Grade Entering: Date of Birth: Gender: (Male or Female) Address: City: Zip: Home Phone: Parent/Guardian Name: Place of Employment: Work Phone: Driver s License Number: Cell
More informationPRINTING INSTRUCTIONS
PRINTING INSTRUCTIONS All forms must be printed in COLOR on standard 8.5 x 11 paper. Black and white or illegible copies will NOT be accepted. 1. The MINOR VEST APPLICATION is a one (1) page form. 2. The
More informationDate of Birth Address City State Zip
RELEASE OF LIABILITY, WAIVER OF CLAIMS, ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT BY SIGNING THIS DOCUMENT YOU WILL WAIVE CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE. You have the right to consult
More information2009 is the age they MUST compete at. If your athlete is 9 now but will be 10 in April, May, or June, they must compete in the 10 year old division.
MONTANA AAU KARATE DISTRICT CHAMPIONSHIPS 610 Professional Dr., Suite 1 Phone: (406) 994-9194 Tournament Date: Saturday, May 9, 2009 Location: Time: Bozeman Senior High School South Gymnasium 205 N. 11
More informationIndividual Waiver. PUEBLO RANGERS, 5v5 or 3v3 SOCCER LEAGUE AND TOURNAMENT WAIVER AND RELEASE OF LIABILITY
PUEBLO RANGERS Individual Waiver Soccer Club PUEBLO RANGERS, 5v5 or 3v3 SOCCER LEAGUE AND TOURNAMENT WAIVER AND RELEASE OF LIABILITY (MUST BE COMPLETED AND PRESENTED AT LEAST 30 MINUTES PRIOR TO YOUR FIRST
More informationFor more information please refer to Board Policy #AP Sep-16
WHEN DO I NEED TO DO A FIELD TRIP REQUEST? CLUB/ORGANIZATION FIELD TRIP ACADEMIC FIELD TRIP Copies of clubs approved field trip request, Emergency Information Form, RCCD Student Excursion Contract, and
More information2013 USACA MEMBERSHIP & INSURANCE
2013 USACA MEMBERSHIP & INSURANCE USACA Membership and Insurance Dues for 2013 Membership and Insurance rates for 2013 will remain the same as 2012 rates Membership and Insurance (general liability and
More information2018 Bowdoin Summer Art Camp Registration
2018 Bowdoin Summer Art Camp Registration Hours and Location Bowdoin Summer Art Camp will run for four weeks from June 25 th through July 27 th, with no classes being held 4 th of July week. The times
More information2015 YOUTH SUMMIT: TOGETHER WE CAN
2015 YOUTH SUMMIT: TOGETHER WE CAN What is Project UNIFY? Project UNIFY is a sports and education program that partners students with and without intellectual disabilities to create a more inclusive school
More informationASTROS RBI FORMS CHECKLIST PARTICIPANT NAME: PARTICIPANT DATE OF BIRTH: / / CONTACT PHONE NUMBER: CONTACT
-ALLTRYOUTSAT URBAN YOUTH ACADEMY 2801S.Vi ct orydr. ;Hous t on,tx 77088 PREREGI STER ONLI NEAT: ASTROS. COM/ UYA FOR OFFICE USE ONLY DIVISION: SOFTBALL JUNIOR SENIOR TRYOUT NO. ASTROS RBI FORMS CHECKLIST
More information22nd Annual Go Shibata Memorial & Brown Belt Championships Texas Judo Inc All Star Event
HOST: Judo Team DATE: LOCATION: SANCTION: WEIGH-IN: Physical Education Activity Building (PEAP) 632 Penberthy Road College Station, Texas 77843 USA Judo Sanction pending Weigh-in and Registration at the
More informationANNUAL LAKE ERIE OPEN WATER CLASSIC
Sunday, July 19, 2015 Sanction Number: EVENT INFORMATION EVENTS: There will be ½-Mile, 1-mile and 2-mile swims on a triangular course in Lake Erie. The start will be in the water. The finish will be on
More informationOHIO STATE UNIVERSITY EXTENSION
OHIO STATE UNIVERSITY EXTENSION SUMMER 4-H CAMP WHERE DREAMS COME TRUE Registration Form June 3-7, 2019 Office Use Only Payment: Cabin: Team: Camper Name_ Home Address Gender Date of Birth Grade in School
More informationPlease fill out both sides of this form!!!
$ # Circle one: Mixed Doubles Rockbridge Hunt Hunter Pace & Trail Ride Please fill out both sides of this form!!! Entry fee: Adult rider (18 and over) -- $35 per horse Junior rider (under 18) -- $20 per
More informationDart Carolina Finish location will be Nags Head, North Carolina. All RUSA rules must be followed info on Dart Rules Team Randonnées
Dart Carolina 2012 Start date will be April 5-8, 2012 covering a minimum of 200k with each 3 to 5 member team finishing 12 hours after their assigned start time. Each team may start its ride between noon
More informationAFCC CAMPER REGISTRATION FORM
AFCC CAMPER REGISTRATION FORM Camper s Name Gender: M F Phone Number Email Address Address City/State/Zip Sponsor or Student Grade Completed (if student): Age Birthdate Church City T-Shirt Size: YM YL
More informationHUMBOLDT BAY ROWING ASSOCIATION JUNIORS 2017 SUMMER SEASON
HUMBOLDT BAY ROWING ASSOCIATION JUNIORS 2017 SUMMER SEASON The HBRA Juniors rowing team is an organization of rowers with the focus of training 11-18 year olds to be competitive rowers. Our goal is to
More informationWELCOME TO STANLY COUNTY GYMNASTICS!
WELCOME TO STANLY COUNTY GYMNASTICS! 1960 Post Rd. Albemarle, NC 28001 Phone: 704-983-2414 Email: stanlycountygymnastics@gmail.com Website: www.stanlycountygymnastics.wildapricot.org Stanly County Gymnastics,
More information2017 Minor Crew Check-List
2017 Minor Crew Check-List Following you will find the necessary forms to complete your 2017 IMSA Membership/License application and Annual hard card application. This checklist is meant to assist you
More informationSo You Think You Can Pow-wow 2016 Registration Form
So You Think You Can Pow-wow 2016 Registration Form Participant Information First Name Last Name Age Address City/town Postal Code Gender E-mail Address Contact Telephone Number/s (306) (306) I AM REGISTERING
More informationNON-EMPLOYEE ACTIVITY RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT
NON-EMPLOYEE ACTIVITY RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT Albright allows Participants to participate in Participant activities that may involve or require overnight
More informationLOCATION & DIRECTIONS:
to benefit Malachi Center s 27th Annual Lake Erie Open Water Swim Urban Kids Swim Camp Sponsered by O*H*I*O Masters Swim Club, Saturday, July 16, 2016 Sanctioned by: Lake Erie LMSC for USMS Inc. EVENTS:
More informationRegistration Form. Special Information (allergies, medical, behavioral, etc) you would like us to know about the gymnast/dancer:
Registration Form Gymnast/Dancer Information Name: Date of Birth (MM/DD/YYYY): School (For Scheduling Purposes): School District (For Scheduling Purposes): Special Information (allergies, medical, behavioral,
More informationVICTORIA CITY ROWING CLUB, a British Columbia society, having its address at 5100 Patricia Bay Highway, Victoria, British Columbia V8Y 2T6
This Agreement made [Date ] BETWEEN: VICTORIA CITY ROWING CLUB, a British Columbia society, having its address at 5100 Patricia Bay Highway, Victoria, British Columbia V8Y 2T6 ( VCRC AND: Full name and
More informationRegistration Form Altius Handcrafted Firearms Biathlon Training Camp July, 2018 West Yellowstone, MT
Registration Form Altius Handcrafted Firearms Training Camp Camp registration is open to participants age 14 (2004 birth year) and older. This is a camp for experienced Biathletes who are looking for both
More information39th Annual BENCH STRICT CURL DEADLIFT APRIL 21, % Raw prior to weigh-ins. $30 for Adults; $15 for athletes 19 & under and Special Olympians.
39th Annual BENCH STRICT CURL DEADLIFT APRIL 21, 2018 MEET DIRECTOR: Jay Siegel engrave2@verizon.net SCHEDULE: All events take place at the BIGLER YMCA 61 Walker Rd. Bigler, PA 16825 Friday April 20, 2018
More informationThe Allegheny River Rumble
Three Rivers Adaptive Sports & Golden Triangle Water Ski Club Presents: The Allegheny River Rumble Sunday August 26, 2018 Golden Triangle Water Ski Club facility on the Allegheny River s Nine Mile Island
More informationMiss North Logan City Pageant Application
Miss North Logan City Pageant Application You re invited to apply for the Miss North Logan City Pageant! Applications need to be returned to North Logan City Office, 2076 N 1200 E, or emailed to northloganrec@gmail.com,
More informationNorth Carolina A&T Summer Youth Programs Let the summer fun begin!
North Carolina A&T Summer Youth Programs Let the summer fun begin! The Office of Extended Learning - Continuing Education and Professional Development would like to thank you for selecting North Carolina
More informationNeighborhood Food Distribution Volunteer Packet
Neighborhood Food Distribution Volunteer Packet Food Bank Coalition of San Luis Obispo County P.O. Box 2070, Paso Robles, CA 93447 Phone (805) 238-4664 Fax (805) 238-6956 www.slofoodbank.org Ethics Agreement
More informationAgreement and Release of Liability
Agreement and Release of Liability MARTIAL ARTS TRAINING / WRESTLING AND FITNESS TRAINING ARE INHERENTLY DANGEROUS AND PHYSICALLY DEMANDING. IF YOU HAVE EXISTING MEDICAL CONDITIONS, BACK PROBLEMS, A HEART
More information