POB 9142, Spokane, WA. 99209-9142    (509) 467-8099

MEMBERSHIP APPLICATION
THE BACKPACKING CLUB RELEASE AND WAIVER OF LIABILITY AND INDEMNITY

I/We, releasor(s), being of lawful age, in consideration of being permitted to participate in activities of The Backpacking  Club, including traveling to and from such activities, do for myself, my heirs, executors, administrators and assigns, hereby release and forever discharge The Backpacking Club, its agents, other participants and activity leaders, their heirs, administrators, executors,successors and assigns, of and from any and every claim, demand, action or right of action, of whatever kind or nature, either in law or in equity arising from or by reason of any bodily injury or personal injuries known or unknown, death or property damage resulting to or from any accident that may occur as a result of my participation in The Backpacking Club’s activities such as hiking, camping, backpacking, snowshoeing, skiing, paddling, or any activities in connection with The Backpacking Club, whether by negligence or not. 
I/We fully understand that the aforementioned activities involve risk of serious bodily injury including permanent disability, paralysis, and/or death.
I/We further release The Backpacking Club, its agents, other participants, and activity leaders from any claim whatsoever on account of first aid, medical treatment or services rendered during my participation in any of the aforementioned activities.
I/We expressly agree that this release, waiver, and indemnity agreement is intended to be as broad and inclusive as permitted by the laws of the State of Washington and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. 
The laws of the State of Washington govern any claim or cause of action arising out of my participation in The Backpacking Club’s activities and venue shall lie in Spokane County, Washington.
I/We acknowledge that I/We have carefully read the foregoing release and know the contents
thereof and sign this release as my/our own free act.


Signature(s)_______________________________________________________________Date___________

_________________________________________________________________________Date___________

_________________________________________________________________________Date___________
Note: If under 18 years of age, child must sign above (if old enough to write) and a parent
must sign above and below.  Sign and complete one line for each child.


Parent’s Signature________________________________________Date_________

        Child’s name & age__________________________

Parent’s Signature________________________________________Date_________

         Child’s name & age__________________________

Parent’s Signature________________________________________Date_________

         Child’s name & age__________________________

PRINT YOUR NAME(S)  AND MAILING ADDRESS BELOW (for mailing newsletter)

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

Phone(hm)____________________________phone(wk)_______________________email______________________

 

Remember, you must  complete the membership application each year and mail it in with your dues check.

Before August 1, 2014, send this Membership Application to: THE BACKPACKING CLUB, POB 9142, Spokane, WA 99209 along with a check for $25 made out to The Backpacking Club.  Note that the dues structure will be modified for anyone joining after August 1, 2014.   Those getting their newsletter online by PDF file will still pay $25 a year.   Those opting to receive their newsletter by mail (U.S. Postal Service) will need to pay $35 a year.

 Questions?  Phone (509) 467-8099.                                                      http://www.backpackingclub.macwebsitebuilder.com