We look forward to hearing from you!
ELARC INC., advocates safe and
enjoyable Operation of all Amateur Radios in Northern Ontario. We promote
recreational Events and work to improve public awareness of Amateur Radio by serving
our community with advocacy activities and much more. Licenses are required for
all participants.
Please complete this form, sign the release, and mail
with appropriate payment to: the Treasurer.
ELARC INC., advocates safe and
enjoyable Operation of all Amateur Radios in Northern Ontario. We promote
recreational Events and work to improve public awareness of Amateur Radio by serving
our community with advocacy activities and much more. Licenses are required for
all participants.
Please complete this form, sign the release, and mail
with appropriate payment to: the Treasurer.
|
ELLIOT LAKE AMATEUR RADIO CLUB INC., MEMBERSHIP
APPLICATION |
2019 |
Please complete this form, sign the release, and mail
with appropriate payment to: the Treasurer.
Membership Types and Dues
NEW! Memberships are good for one year from the date of application!
Membership
Type: (check one) Individual: $25.00 ____ Family: $40.00______ Associate:
$5.00_____Junior: $10.00_______
Primary Adult
Member's Information: (print clearly) Name: __________________________________
Address:_________________________City:_____________Province:__________Post-Code:__________
Email Address:________________________Phone
Number:______________
Interests: Contests Picnics Advocacy Social Other?
Call Sign:
Why are you joining the club?
Additional Family Member Names:
(print clearly)
Name: Name:
Name: Name:
All members must read and sign the
Release and Waiver of Liability, Assumption of Risk and Indemnity Agreement,
provided with this application. By signing, you confirm that you have read and
agree to the terms of the Agreement. Unsigned applications will be rejected and
returned to the applicant.
Signature
of Primary Adult Member: Date:
Signatures of ALL Additional
Family Members 15 years and older:
Member:
_____________Date: ______Member: _______________Date: ______
Member:
_____________Date: ______Member: _______________Date: ______
Minors (under 15) must have a parent
or legal guardian with them on all Events,
Release and Waiver of Liability, Assumption of Risk and Indemnity
Agreement. In consideration of being
permitted to participate in any way in ELARC INC., sponsored Activities
("Activity") I, for me, my personal representatives, assigns, heirs,
and next of kin:
Acknowledge, agree, and represent
that I understand the nature of Event Activities and that I am qualified, in
good health, and in proper physical condition to participate in such Activity.
I further acknowledge that the Activity will be conducted in public places and
facilities open to the public during the Activity and upon which the hazards of
traveling are to be expected. I further agree and warrant that if at any time I
believe conditions to be unsafe, I will immediately discontinue further participation
in the Activity.
I Fully Understand that:
·
Activities involve risks and dangers of serious bodily injury,
including permanent disability, paralysis and death ("risks");
·
These risks and dangers may be caused by my own actions or in-actions,
the actions or in-actions of others
participating in the Activity, the condition in which the Activity takes place,
or the Negligence of the "releasees" Named Below;
·
There may be other risks and social and economic losses either not
known to me or not readily foreseeable
at this time; and I fully ACCEPT AND ASSUME ALL SUCH RISKS AND ALL
RESPONSIBILITY FOR THE LOSSES, COSTS AND DAMAGES I incur as a result of my
participation in the Activity.
I HEREBY RELEASE, DISCHARGE, AND
COVENANT NOT TO SUE the Club, ELARC INC., Members, their respective administrators,
directors, agents, officers, volunteers and employees, other participants, any
sponsors, advertisers, and, if applicable, owners and lessors of premises on
which the Activity takes place (each considered one of the "RELEASEE"
HEREIN) FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES OR DAMAGES ON MY ACCOUNT
CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE
"RELEASEES" OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS; AND
I FURTHER AGREE that if, despite this RELEASE AND WAIVER OF LIABILITY,
ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT I, or anyone on my behalf, makes a
claim against any of the Releasees, I Will Indemnify, Save, and Hold Harmless
Each of the Releasees from any litigation expenses, attorney fees, loss,
liability, damage, or cost which any may incur as the result of such claim.
I HAVE READ THIS AGREEMENT, FULLY
UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE
GIVEN UP SUBSTANTIAL RIGHTS BY
SIGNING IT, AND HAVE SIGNED IT FREELY AND WITHOUT ANY INDUCEMENT OR ASSURANCE
OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL
LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION
OF THIS AGREEMENT IS HELD TO BE INVALID THE BALANCE, NOTWITHSTANDING, SHALL
CONTINUE IN FULL FORCE.
Signature Date: