VALCOUR SAILING CLUB

P.O. BOX 1362

PLATTSBURGH, NEW YORK  12901  

www.valcoursailingclub.org  

2005 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        ________ Extra Boat Fee $1 

                              _______ Associate Membership $50         ________ Crew Membership  -- $10 donation

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 30, 2005 to:

Valcour Sailing Club

P.O. Box 1362

Plattsburgh, NY 12901

Thank you!