CAPE MAY COUNTY ARCHERY ASSOCIATION

MEMBERSHIP APPLICATION

2009-2010

 

 

TYPE OF             TYPE OF MEMBERSHIP/DUES (CHECK ONE)                                                                                                      

        _____SINGLE MEMBERSHIP                                                  $50.00 Plus 12 Hours work

        _____NON-WORKING SINGLE MEMBER                           $75.00

        _____COUPLE MEMBERSHIP                                                $60.00 Plus 12 Hours work

        _____NON-WORKING COUPLE MEMBERSHIP               $85.00

        _____FAMILY MEMBERSHIP                                                 $65.00 Plus 12 Hours work

        _____NON WORKING FAMILY MEMBERSHIP                 $90.00

        _____SENIOR MEMBERSHIP (65 YRS OLD & OLDER)   $20.00

        _____JUNIOR MEMBERSHIP (UNDER 18 WITH LEGAL GUARDIAN PERMISSION) - $15.00

  

                      NAME: _____________________________________________________________________________

 

                     ADDRESS: __________________________________________________________________________

 

                      CITY, STATE, ZIP CODE______________________________________________________________

 

                      DATE OF BIRTH_______________PHONE__________________

                      FOR FAMILY OR COUPLES MEMBERSHIP: SPOUSES NAME: _______________________________

                    CHILDREN UNDER 18 (BIRTH DATE MUST BE AFTER (September 1, 1991 to qualify)

   NAME: _______________________________________    DATE OF BIRTH: ____________________

   NAME: _______________________________________    DATE OF BIRTH: ____________________

   NAME: ________________________________________   DATE OF BIRTH: ____________________

   NAME: ________________________________________   DATE OF BIRTH: _____________________  

   VEHICLE #1 MAKE/MODEL___________COLOR:__________LICENSE PLATE#__________STATE___

   VEHICLE #2 MAKE/MODEL___________COLOR__________LICENSE PLATE#__________STATE____

   EMAIL ADDRESS;____________________________________________________________________________

    _____PLEASE SEND ME VIA E-MAIL ANY PERTINENT NOTICES OR INFORMATION ABOUT THE CLUB.

     MAIL COMPLETED APPLICATION AND CHECK PAYABLE TO:

                                              CMCAA

                                              PO BOX 129

                                              VILLAS NJ 08251

 

 

                                                                                                          CMCAA USE ONLY

                                           DATE________________   TYPE: S   C   F   SR  J     AMOUNT PAID$____________ VIA____________

                                          MEMBER#__________________ ADDITIONAL MEMBERS: _______#,________#,_______#,_________#,                      

 

PLEASE SUPPORT OUR MONTHLY SHOOTS HELD THE THIRD SUNDAY OF EVERY MONTH. 

 CHECK TCAA SCHEDULE

 **WAIVER ON BACK PAGE MUST BE SIGNED**

 

 

 

 

 

 

Waiver/Release

ARCHERY CLUB WAIVER AND RELEASE OF LIABILITY

READ BEFORE SIGNING

 

In Consideration of being allowed to participate in any way in CAPE MAY COUNTY ARCHERY ASSOCIATION  Legal name of your Archery Club

Events and activities the undersigned acknowledges, appreciates and agrees that: 

1)      The risk of injury from archery and other known and unknown events and activities and/or the use of the related buildings, structures, equipment, automobiles,  firearms, weapons, ATV’s, boats, tree stands, roads, bodies of water, land and all other real and personal property whether owned by archery club or others is significant, including the potential for permanent paralysis and death, and while  particular rules, equipment and personal discipline may  reduce this risk, the risk of serious injury does exist; and

2)       I acknowledge and agree that the use of archery equipment, firearms and other weapons my myself or others on club premises or otherwise are inherently dangerous and high risk activities whether such archery equipment, firearms or weapons are discharged by myself  or others; and

3)       I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for participation; and,

4)       I willingly agree to comply with the stated and customary terms and conditions for participation. If however, I observe and unusual significant hazard during my presence or participation. I will remove myself from participation and bring such to the attention of the nearest official immediately; and

5)    I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS CAPE MAY COUNTY ARCHERY ASSOCIATION (Legal name of your archery club) its officers, directors, officials, agents, employees, volunteers, members, guest, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of real property and personal property used to conduct the events and activities (“RELEASEES”), WITH RESPECT TO ANY AND ALL INJRY, 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 HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT. FULLY UNDERSTAND ITS TERMS. UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

 

__________________________________________                                                                                         Participant’s Name

_________________________________________                    Date Signed:_________________________

Participant’s Signature

 

FOR PARTICIPANTS OF MINORITY AGE

(UNDERAGE 18 AT THE TIME OF PARTICIPATION)

This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releasees, and myself, my heirs, assigns, and next of kin. I release and agree to indemnify and hold harmless the Releasees from and all liabilities incident to my minor child’s involvement or participation in these events and activities and/or the use of related real and personal property as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE.

 

__________________________________________

Name of Parent/Guardian

 

__________________________________________                   Date Signed_________________________

Parent/Guardian Signature

Emergency Phone Number: (            )________________                 

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