2006
Membership Application
Name:_____________________________________________________________________
Address:__________________________________________________________________
City: _______________________________ State: _________________ Zip: __________
Telephone: ____________________ Email: ______________________________________
Do you own a sailboat? Yes _____ No _____
Make and model of boat: ______________________ Boat Name: ____________________
Sail Number:_____________________________________
Type of Membership:
_______ Regular Membership $250 (before May 6, 2006), $275 (after May 6, 2006)
_______ Extra Boat Fee $1
_______ Associate Membership $50
_______ Crew Membership -- Free!
Release and Waiver of Rights
In
consideration of Valcour Sailing Club’s acceptance of my membership and of the
volunteer efforts of its officers and committee members, I waive and release any
and all claims that I may or will have against Valcour Sailing Club, its
officers, committee members and volunteers, for damages or injury to property or
person, or loss of life, arising out of my entry and continued participation in
any Valcour Sailing Club activity. I
agree to require all persons that I may invite to participate in a Valcour
Sailing Club sailboat-racing event to sign an original of this form prior to
participating in the event and will mail the signed form to the Valcour Sailing
Club before or as soon as possible after the event.
I certify that I am knowledgeable in the rules, practices and associated
risks of sailboat handling and racing. I
certify that any boat I may enter or skipper in any Valcour Sailing Club event
is insured by a properly licensed insurance provider against liability for
damage or injury, including loss of life, to persons or property in an amount
reasonable under the circumstances of the event.
I further certify that I, and any boat that I may enter or skipper in any
Valcour Sailing Club event, will comply with all laws and regulations
promulgated by any applicable federal, state, or local authority and by the
Valcour Sailing Club, including those regarding safety equipment and devices.
I certify that I
have read and fully understand the above.
Signature:____________________________________
Date: _________________________
Please mail your
completed application and membership fee(s) by April 6, 2006 to:
Valcour Sailing Club P.O. Box 1362 Plattsburgh, NY 12901 Thank you!