Canoe & Kayak Club of Augusta
(CKCA)
Please PRINT the following information, as you want to be listed in the CKCA Membership Directory. (Limit 2)
Address: ________________________________________________________________
City, State, Zip: __________________________________________________________
E-mail Address: _______________________
Other Family Members: ____________________________________________________
What type paddling do you prefer?
¯ Canoe___ Kayak___ Other___
¯ Day Trips___ Weekend Trips___ Other_______________________________
I, ______________________________________________________________, apply for membership in the Canoe & Kayak Club of Augusta (CKCA) and enclose $15 for individual or $20 for family annual membership dues.
Assumption of Risk & Responsibility & Release of Liability
I, _____________________________________________________________, in consideration for membership in the Canoe & Kayak Club of Augusta (CKCA) & to become a joint adventurer in CKCA activities, hereby declare as follows. I understand that boating & other activities in which I will engage with CKCA are inherently dangerous & will expose me to various hazards, both natural & man made, which could result in significant risk of injury (including permanent disability & death) as well as severe social & economic losses. I know & appreciate the dangers described above. I choose to proceed with CKCA activities & expressly assume & accept full responsibility for the consequences of my exposure to all risks, hazards & dangers I may encounter as a joint adventurer in any CKCA activity. I release & agree to hold harmless & not to bring any legal action against CKCA, its directors, officers, leaders, coordinators, instructors, members, or guests, either personally or as representatives of CKCA, arising out of or relating to any & all claims, demands, damages, injuries to person or property, actions or causes of action for any acts of active or passive negligence (except for willful or wanton negligence or misconduct), arising out of or connected with participation in any CKCA activity. This release is given to enable my joint adventurers & me to feel free to participate in CKCA activities & to donate our services to help each other without fear of liability. This release is given in consideration for similar releases granted or to be granted to my benefit by other CKCA members & joint adventurers on CKCA activities. This release has no expiration date & shall be deemed reaffirmed each time I participate in any CKCA activity.
I have read & understand the above assumption of risk & responsibility. I sign it voluntarily & knowingly thereby give up substantial rights.
Signature _____________________________________ Date _______ Age _____
Signature _____________________________________ Date _______ Age _____
Signature _____________________________________ Date _______ Age _____
Signature _____________________________________ Date _______ Age _____
(If any of the above is under the age of 18 years old, the following must be signed by a parent/legal guardian.)
I, ____________________________________________ (signature), have read & understand the above waiver & release of liability & agree to be bound by its provisions. As parent/legal guardian of the above named minor(s), I hereby grant permission for him/her/them to participate in the CKCA events & activities.