Online Application

East Tennessee Mogul Mashers

PO Box 5516

Kingsport, TN 37663

Application for Membership

November 1, - October 31,

$30 Individual Renewal $35 Individual $55 Family Renewal $65 Family

First Name:	M: Last Name:
Address:
City:	State: Zip:
Phone (Home):	Phone (Cell):
Date of Birth:	Email (Home):
Email (Work):	Phone (Work):
Spouse:
Phone (Work):	Anniversary:
Date of Birth:	Phone (Cell):
Email (Work):	Email (Home):

RELEASE AND HOLD HARMLESS AGREEMENT

The undersigned hereby acknowledges that hazards are inherent in the sport of skiing and other club sports and activities and hereby assumes all risks of injuries or damages incidental to such sports and activities. In consideration of the benefits derived from joint participation, by membership in the East Tennessee Mogul Mashers Ski Club, in skiing and other sports and activities, the undersigned does hereby absolve, release, and waive any and all liability, claims or demands against the East Tennessee Mogul Mashers Ski Club, and its officers, directors and each and every member thereof which may arise out of or be related to any injury, damage or pecuniary loss by reason of such club membership or sport activity of participation in said club. Included, but not limited to, this general release is all causes arising of nonfeasance, malfeasance of the Ski Club, its officers or Board of Directors. (Family: The undersigned, as father and mother and/or guardian(s) of LIST ALL CHILDREN UNDER 18 YEARS OF AGE).

Minor:	Date of Birth:
Minor:	Date of Birth:
Minor:	Date of Birth:

For the consideration set forth above, the undersigned do hereby further release, acquit, discharge, and covenant to hold harmless the East Tennessee Mogul Mashers Ski Club and its officers, directors and each and every member thereof from any and all liability, claim or demand arising out of or from participation in said club activities by said minors. The undersigned further promise to bind themselves jointly and severally, their heirs and assigns of any sum of money that any said parties may hereafter be compelled to pay of the behalf of said minor because of any and all said claims.

Witness my hand this day of , , after carefully reading the foregoing and agreeing and signing as my own free act.

Individual / Father Signature:

Spouse / Mother Signature:

Comments or other info:

Payment can be mailed to address at top of page or brought to monthly meeting.