Chugiak Dog Mushers Association

Chugiak Dog Mushers Association

PO Box 671523 - Chugiak, AK 99567
Senior Membership Form (Effective Aug. 1, 2017 through July 31, 2018)
Membership and Trail Pass

Adult Day Pass $ 10.00

Adult Individual Membership $ 35.00

Adult Dual Membership $ 50.00

Lifetime Membership (Individual) $ 300.00

Annual Trail Pass $ 40.00

After-hours Permit $ 25.00

Total: $ 0.00
Name *

First Name Last Name
Name 2 *

First Name Last Name

Address *

Street Address
Street Address Line 2
City	State
Zip Code	Country

E-mail *
E-mail 2
example@example.com
Cell Phone

- Area Code Phone Number
Cell Phone 2

- Area Code Phone Number
Phone

- Area Code Phone Number
After-Hours Permit

I plan to use Beach Lake Park after 11 pm.
Vehicle License Plate
Make/Model
Color
Year
Liability Release

I (We) understand that dog mushing and dog-powered activities can be dangerous and can cause injury. I (we) also understand that no one can foresee the many causes of injuries, or the many possible types of injuries, related to dog mushing and dog-powered activities. On behalf of myself (ourselves), individually, and on behalf of our children, if any, I (we) release from any and all liability (and agree not to sue or bring claims against) the Chugiak Dog Mushers Association and the Municipality of Anchorage, should I (we), any guest of mine (ours) or any member of my (our) family, including my (our) children be injured at the Beach Lake Trail System or during any event hosted by the Chugiak Dog Mushers Association. This release includes claims relating to all injury of any sort, including fatal injury and injury that is not foreseeable at this time.

THIS IS A LEGAL DOCUMENT - Read before signing
Signature
Signature 2
Date *

- Month - Day Year
PLEASE BE ADVISED... Photos and videos may be taken while you are participating in Chugiak Dog Mushers Association (CDMA) public events, or using the Beach Lake Sled Dog Trails, which are located on public land. Your name, your dogs' names, and likeness(es) may be used in promoting or advertising CDMA events, including but not limited to the CDMA website, facebook pages, race poster and publication of race results.
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