Southern Arizona Paddlers Club Application
I/We wish to join or renew membership to the Southern Arizona Paddlers Club. Please enroll me/us as a new or returning member(s).
** All new and renewing members must sign and submit the SAPC release of liability form attached with this application.
Check any of the choices for yearly membership (from January to December).
[ ] $15 Individual or Family [ ] $5 each additional voting membership
[ ] New [ ]Renewing
Name(s) _______________________________________________________________
Address _______________________________________________________________
City ______________________________________ Zip Code__________________
Phone (home) __________________________________________________________
E-mail address _________________________________________________________
Today's Date_______________________________________________
Interest (circle all that apply): Inflatable kayak Hard-shell kayak Canoe Raft Sea kayak
Water type: Flatwater Whitewater
How did you hear about us?___________________________________________
[ ] Check
here if you prefer not to have your data published on the club roster.
A revised club
roster and other SAPC updates & news grams will be emailed periodically to
current club members only. Current status is annual from January of every calendar
year.
Anyone joining in November or December will be granted membership for the
following year.
When applying or renewing at club meetings, please bring both signed application and waiver forms with your check or cash.
Please make checks payable to: SAPC P.O. Box 41443 Tucson, AZ 85717-1443
For more SAPC info go to: www.soazpaddlers.org or Email: Info@soazpaddlers.org
SAPC President: Steve Anderson,
520-297-6881 Email: president@soazpaddlers.org
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(Retain this section for your records)
SAPC membership receipt Date:__________ Total paid:___________
Paid by:_______________________________
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SAPC WAIVER AGREEMENT
* * READ CAREFULLY - THIS IS A WAIVER AND RELEASE OF LIABILITY I, the undersigned, hereby acknowledge that I fully understand and accept that there are certain hazards and elements of danger inherent in many if not all activities which are beyond the control of the members, officers, and trip initiators of the Southern Arizona Paddlers Club. I realize that my participation in these activities may result in personal illness or injury, due to accidents, the forces of nature, or other causes not foreseeable. Such illness and injury may include disease, strains, sprains, fractures, dislocations, paralysis, and/or death. Possible injuries may cause serious and permanent disability. I also realize that my participation in the various activities may result in the loss of or damage to personal property.
Now therefore, intending to be legally bound, I hereby waive, for myself, and anyone else claiming through me, my right to sue or recover damages from the Southern Arizona Paddlers Club, its members, officers, and trip initiators for any illness or injury to my person, loss of life, and any damage or loss of personal property which may arise out of my participation in the Southern Arizona Paddlers Club’s activities. The wavier applies to any negligent act or omission and to any intentional act intended to promote my safety or well-being.
I understand that the Southern Arizona Paddlers Club
sponsors "cooperative adventures", where the group is collectively responsible for
the conduct of the activities. Further, I understand that no one but myself is responsible for
judging my qualifications or for my safety when I choose to participate in any activity. I
have received, read, understand, and accept the contents of the Southern Arizona Paddlers Club
Trip Policy Statement. I further state that I am legally competent to sign this waiver and
release of liability; and that I understand that the terms herein are contractual and not a
mere recital. I have read this waiver before signing it, and I have signed it voluntarily. This
waiver has no expiration date.
________________
___________________________________ ___________________________________
Date
Printed
Name
Signature
________________
___________________________________ ___________________________________
Date
Printed
Name
Signature
Dependents over 18 years old:
________________
___________________________________ ___________________________________
Date
Printed
Name
Signature
________________
___________________________________ ___________________________________
Date
Printed
Name
Signature
PARENTS OF MINORS: I give permission for my
son(s)/daughter(s) to participate in the activities of the Southern Arizona Paddlers Club. I
waive the rights described above with respect to the below named minor(s), and I further agree
to indemnify the Club, its members, and trip initiators from any claims arising from the
participation of the below named minor(s).
________________
___________________________________ ___________________________________
Date
Minor’s Printed
Name
Parent or Legal Guardian Signature
________________
___________________________________ ___________________________________
Date
Minor’s Printed
Name
Parent or Legal Guardian Signature
________________
___________________________________ ___________________________________
Date
Minor’s Printed
Name
Parent or Legal Guardian Signature
________________
___________________________________
___________________________________
Date
Minor’s Printed
Name
Parent or Legal Guardian Signature
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