Cerbat Ridge runners ATV Club (CRRATVC)
Membership Application and Release of Liability Form
(One application per member)
Date of application:______________________Name:____________________________________________________
City:_________________________State:_________Zip:________ Cell Phone #: _____________________________
Hm phone #: ____________________________#of family members:__________Head of Household:______________
I hereby agree, if accepted as a member of the CRRATVC, to abide by the charter and By-Laws of the CRRATVC involving all club activities and to promote safe and responsible ATV-OHV Usage.
Applicant Signature: __________________________________________
I, _____________________, age____, do hereby forever hold harmless the Cerbat Ridge Runners ATV Club and their heirs, Executors, administrators, directors, officers, successors and assigns, from every right and claim which I may now have, or may hereafter have, on account of any injuries, disabilities and/or illness suffered by me as follows :
ANY CRRAVTVC FUNCTION THAT I MAY PARTICIPATE IN, WHICH INCLUDES MEETINGS, RIDES, OR ANY OTHER FUNCTION.
I hereby acknowledge that by signing this RELEASE I am forever settling in full for any injuries, disabilities and/or illness which I have previously had, which I now have and which I may have in the future, either on account of the specific occurrence mentioned above, or because of any occurrence in the past, or because of both, even though I do not know that I already have had, have now or may in the future have such injuries, disabilities and/or illnesses, and even though they are not mentioned in this release, and I do this regardless of what any person or persons may have told me about my injuries, disabilities and/or illnesses, or about anything else.
I KNOW THAT DOCTORS, LAWYERS AND OTHERS MAKE MISTAKES AND I REALIZE THAT WHAT OTHER PEOPLE MAY HAVE TOLD ME COULD BE WRONG. I REALIZE I AM TAKING THE RISK THAT THEY MIGHT BE WRONG ABOUT MY CASE; AND IF THEY ARE WRONG, IT IS MY LOSS AND I CANNOT BACK OUT OF THIS RELEASE OF LIABILITY AGREEMENT.
I am signing this LIABILITY RELEASE in exchange FOR ONLY THE PRIVILEGE OF RIDING WITH THE CLUB, and I have not been promised anything else.
RIDER: Please answer the following questions in your own handwriting:
1. Have you read this paper from beginning to end? X __________
2. What is this paper you are signing? X ________________________
3. Do you realize that signing this paper forever settles and ends every right and/or claim which you may now have or any damages, as well as for past or future, care, cure, maintenance and/or wages? X ______
4. Are you satisfied with this AGREEMENT? X ________
THEREFORE, I am giving my word by signing below to show that I understand everything that is said in this paper.
THIS IS A RELEASE
Signature: ___________________________________________________ Date: _______________________
If minor, parent must sign for minor_____________________________________________________________
SECRETARY/Membership Chair:_________________________________ DATE OF APP RECEIPT: ________________
TREASURER: _________________________ DATE OF FEE PAID: _________________AMOUNT: $ ___________
PRESIDENT/VICE PRESIDENT SIGNATURE: _______________________________ DATE APPROVED: ______________