Phone (day)

(night)

Email

Name of Additional Family Members

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For the purposes of this application, the word “canoe” refers to any watercraft propelled by paddling. 

Have you had formal canoe training?

Yes

No

If so, what kind?:

How many years have you paddled?

Type or Class of Water:

Special Interest(s), i.e., open boat, kayak, free-style, etc.

Can you swim?

Yes

No

NEW MEMBERS: Referring Member's Name:

WAIVER

In consideration of and through my involvement in Hunterdon County Canoe Club, I acknowledge and agree that: 

1. There are inherent risks in the sport of canoeing, and the sport can require extreme degrees of physical exertion, special knowledge, skills, and/or equipment;
2. I risk bodily injury, including paralysis, dismemberment, and death, as well as loss of or damage to property
3. I assume full responsibility for any pre-existing medical conditions I may have, and the risk that I undertake in participating in canoe club activities with these conditions;
4. I knowingly and freely assume all risks; and I, for myself, and on behalf of my heirs, assigns and next of kin, hereby release, hold harmless and promise not to sue the Hunterdon County Canoe Club, its officers, officials, agents and/or employees, with respect to any and all such injury, paralysis, dismemberment, death, and/or loss or damage (except that which is resultant of gross negligence and/or willful or wanton misconduct).

PARTICIPANT’S SIGNATURE :

PARTICIPANT’S SIGNATURE (if minor):

DATE: