HRCKC 2026 Application and Liability Waiver

2026 Hackensack River Canoe & Kayak Club Membership Application & Participant Release of Liability Waiver
This form is for online completion ONLY. It is NOT for printing. A printable form is at https://hrckc.org/images/docs/2026_Membership_Application_and_Waiver.pdf
Your Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Cell Phone Number

Area CodePhone Number
Home/Office Phone Number

Area CodePhone Number
Email*
example@example.com
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number

Area CodePhone Number
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.
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.
by credit/debit card or PayPal after submitting this form or via the “Dues Payment” link on the “membershipapplication & guest waiver” page on www.hrckc.orgby check payable to "HRCKC" mailed to 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 RELEASEE'S 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 the activity and bring such hazard to the attention of the nearest coach or team leader 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 and equipment used to conduct club activities (“RELEASEE'S”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEE'S OR OTHERWISE.

I also acknowledge that photographs and video may be taken of me in my participation in, and attendance at this club activity, and hereby freely agree to allow without restriction all uses of such photos and videos in the reporting of this club activity, and 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.
Signature*

Clear
Signed by*

First NameLast Name
Date*

MonthDayYear
Date
For the convenience of those paying dues online, a payment page will appear when you submit this form. If this is not applicable to you (e.g. paying by check, 2nd adult in a family membership, life member or previously paid) please ignore and close that page.
Should be Empty:

2026 Hackensack River Canoe & Kayak Club Membership Application & Participant Release of Liability Waiver

Signature required below