Conewago Canoe Club Membership Application for 2008

Memberships run from January 1 through December 31

Please read the folowing carefully before signing this application

This waiver is freely given in the interest of permitting the Conewago Canoe Club (hereinafter referred to as the CCC) to exist and enable myself and my fellow paddlers to donate our services and help each other without fear of liability. My waiver is given in exchange for similar waivers given by other members of the CCC and has no expiration date.

I hearby declare that I fully understand that any boating activity exposes participants to various hazards. I am aware that even skilled and prudent paddlers can experience emergencies. The risks I may encounter have been duely considered and no one other than myselfcan be held responsable for my safety. Ialso declare that I will follow recommended safety practices i.e. wearing of life jackets etc. and practice river courtisies while boating

I hearby waive, release and discharge for myself, my personal representatives, my heirs and any member of my family any and all claims for damages for personal injury, property damage or death which I may have or which may hereafter accrue to me against the CCC, its members, trip coordinators or any of my fellow paddlers as a result of my participation in any club sponsored activity.

Name ___________________________		E-Mail ________________________
Street Address ____________________	Phone # _______________	Cell Phone # ___________________
City____________________________	State__________________	Zip Code ______________________

Number of family members under 18 as of January 1st 2008 ______________

The annual dues are $20.00. Please make your check payable to Conewago Canoe Club.

Send toEvy Stauffer P.O. Box 3365 York Pa. 17402-0365

Please add any addition donation to the Conewago Canoe Club Scholarship Fund

Newsletter is mailed by bulk mail. If you would like your newsletter mailed first class, please add 5 dollars

Annual Dues	_________________
Scholarship Fund Donation	_________________
First Class Postage	_________________
Total Remittance	_________________

Signature of Applicant	_________________________________	Date _____________
Signature of Parent/ Guardian for those under 18	________________________________	Date _____________

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