MNC Membership '19-'20

MNC Membership '19-'20 Season

including Ethan Allen Firing Range Rules and Waivers
Full Name*

First NameLast Name
Family Member 2

First NameLast Name
Family Member 3

First NameLast Name
Family Member 4

First NameLast Name
Family Member 5

First NameLast Name
Family Member 6

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area Codeex: 333-3333
E-mail*
ex: myname@example.com
Membership Selection

My Products

Youth (under 18)$10.00

Quantity
Item subtotal:$0.00

Adult$25.00

Quantity
Item subtotal:$0.00

Family$55.00

Enter coupon

Total $0.00

Upon completion of the order form you will be directed to the MNC checkout site for payment processing.

Payments may be made via Credit/Debit card or PayPal account.

If you have any problems with your order, please email info@mansfieldnordic.org

How did you find out about Mansfield Nordic club?

Prior MemberWord of MouthWebsiteFront Porch ForumTent/Banners at Race VenueOther

Release and Indemnification

Must be completed by each participant or a parents if participant is under 18
EMERGENCY RELEASE AUTHORIZATION:

Completion of this section serves as consent for medical treatment for the named athlete in the case of a medical emergency and/or in the case of other timely medical care if the attending physician and the MNC team coaches are unable to contact the consenting parent or guardian, or if the athlete of majority age is unable to consent at the time. *
In order to access the Biathlon Training Facility, all athletes must be in a group of two or more. Any individuals found training on their own will be asked to leave for the day and risk losing their access privileges in the future.*

Agree
The speed limit is 25 mph on every road within the National Guard training facility. Not only are there military personnel to enforce this, there are also a large number of police using the various ranges. Obey the speed limit! If you are seen speeding you will be asked to leave*

Agree
Any day that a group is training the coach will need to stop at Range Control (Red House) to sign in and make sure that the training area is safe for use.*

Agree
Any athlete using rollerskis must be wearing a helmet! If you are seen without a helmet you will be asked to leave.*

Agree
Ski in the proper direction on all trails. The only time this may change is during a race event. If you are unsure, ask someone who knows. Teams or individuals caught skiing against the flow of traffic will be asked to leave, possibly for the rest of the training year.*

Agree
A large red Range Flag is flown when biathletes are shooting on the range. Do not ski down range (between firing line and targets and behind targets) at any time regardless whether or not the range flag is raised.*

Agree
Large artillery is often being discharged in close proximity to the ski trails. DO NOT SKI UNDER ROPES across trails. If you are unsure about where it is safe to ski, check with military personnel or simply stay away from areas that seem unsafe*

Agree
If barriers have been placed in the road restricting vehicle access to the range, do not drive around barriers to access training facility.*

Agree

Liability Release - Vermont Army National Guard

In consideration of use for the military range, I freely accept and voluntarily assume ALL RISK of personal injury or death or property damage. I specifically acknowledge the risks associated with firing weapons, which can include severe personal injury and even death, and hereby assume the risk of firing said weapons.
If I am signing on behalf of a minor, I hereby certify that I have full authority to act as his/her legal guardian and in that capacity I understand that in case of injury or illness of the minor, I will be notified. If it is impossible to contact me and it is an emergency, I hereby give permission for an attending physician to treat, hospitalize, administer anesthesia, or to order injections or surgery for the safety of the minor child.
I hereby agree to fully indemnify and hold the Vermont National Guard and the State of Vermont and to the extent applicable the United States Armed Forces, harmless from any and all damages or losses or actions or any kind brought by any person, including the minor, which arises out of the participation in and/or attendance at the activities of the Ethan Allen Biathlon Center of Excellence training program and related events.
I hereby release, remise, discharge and covenant not to sue the State of Vermont, Vermont National Guard, and in so far as applicable, the United States and the United States Armed Forces, and its agents, volunteers and employees from any and all liability for personal injury or death or property damage which results in any way from negligent actions and/or omissions of employees, volunteers and/or agents of the Vermont National Guard, the State of Vermont or the United States Armed Forces, arising out of the conditions on or about the premises and the facilities used for the Ethan Allen Biathlon Center of Excellence training program, including but not limited to natural or man-made obstacles and its placement, visibility or condition or my participation in any activity during the Ethan Allen Biathlon Center of Excellence training program
ACCEPTING MYSELF THE FULL RESPONSIBILITY FOR ANY AND ALL SUCH INJURY OR DEATH OR DAMAGE OF ANY KIND WHICH MAY RESULT. I ESPECIALLY AGREE TO ASSUME ALL RISK OF PERSONAL INJURY OR DEATH OR PROPERTY DAMAGE ASSOCIATED WITH PARTICIPATION IN THE EVENT.
I and all adults on this form agree with the above statements regarding liability and I take full responsibility for myself and others I am responsible for under the above agreement*

AgreeAgree (adult #2)Agree(Consenting Parent or Guardian for athletes
Should be Empty:

MNC Membership '19-'20 Season

Membership Selection

Release and Indemnification

EMERGENCY RELEASE AUTHORIZATION:

Liability Release - Vermont Army National Guard

ACCEPTING MYSELF THE FULL RESPONSIBILITY FOR ANY AND ALL SUCH INJURY OR DEATH OR DAMAGE OF ANY KIND WHICH MAY RESULT. I ESPECIALLY AGREE TO ASSUME ALL RISK OF PERSONAL INJURY OR DEATH OR PROPERTY DAMAGE ASSOCIATED WITH PARTICIPATION IN THE EVENT.