Release Of Liability Waiver

2024 Hackensack River Canoe & Kayak Club Membership Application & Participant Release of Liability Waiver
Your Name*

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Home/Office Phone Number

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Email*
example@example.com
Contact information is shared only with trip coordinators in order to enable them to confirm membership status and to contact you if needed.
I am over the age of 18.
I am applying for/renewing membership as a(n):*

Individual Member ($15)Family - 1st Adult (Family Membership is $25 and covers 2 adults in same household, 2nd adult MUST also submit this form.)Family - 2nd Adult (in a Family Membership)Life (founding) Member
Membership Year ends on December 31st. New members joining from October 1st will have dues waived for the following year.
How do you wish to pay*

I have paid or will pay by credit/debit card or PayPal (link on membership application page at www.hrckc.org)I have sent or will send a check to HRCKC, c/o Peter Walker, 24 Northview Ter, Cedar Grove, NJ 07009Other
If you are a new or recent member please tell us how you learned about the club. Any other comments or questions are also welcome.
Signature required below
In consideration of being allowed to participate in any way in this sports activity, related events and activities, the undersigned acknowledges, appreciates, and agrees that: The risk of injury or illness from the activities involved in this sport 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 or illness does exist; and, 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 my participation; and, I willingly agree to comply with the stated and customary terms and conditions for participation.

If I observe any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such hazard to the attention of the nearest official immediately. I verify that I will only participate in club activities, on and off water, while in good physical and mental health and that I will not consume any mind altering drugs or alcohol prior to or during club activities that may impede my ability to participate putting myself or others at risk. I will inform the coach or team leader at the beginning of any on water activity if I am not feeling well or have a medical condition and remove myself from the activity.

I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS PADDLESPORT RISK MANAGEMENT, LLC; HACKENSACK RIVER CANOE AND KAYAK CLUB; CHRIST EVANGELICAL LUTHERAN CHURCH; their officers & directors, officials, agents, and/or employees, other participants, sponsoring agencies, commissions, sponsors, advertisers, volunteers, coaches, steerers, and, if applicable, owners and lessors of premises used to conduct club activities or special events (“RELEASEES”), 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.

I also acknowledge that photographs and video may be taken of me in my participation in, and attendance at this event, and hereby freely agree to allow without restriction all uses of such photos and videos in the reporting of this club activity or race, and/or in the promotion of the club, its location, other sporting events, sport in general, and/or related purposes.

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.
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2024 Hackensack River Canoe & Kayak Club Membership Application & Participant Release of Liability Waiver

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