e-mail: ________________________________________________
Home Phone: (____)__________________ Work Phone: (____)__________________
Cell: (____)__________________
Address:________________________________________________________________________
Street: ____________________________________
City: ____________________________________ State: ________ Zip: ____________
This is a release of liability in any club events or activities. Please read it carefully before you sign. Signing this form is a precondition to participating in club events and activities.
1. I understand that the Milwaukee Adventure Club is constituted as a group of like-minded individuals who have organized for the purpose of enjoying each other’s company in a variety of activities, and that said activities are considered a voluntary assembly by friends for mutual enjoyment in a social situation. Furthermore, the Milwaukee Adventure Club is a parent organization only in the sense that it may facilitate such assemblies. Each individual is acting as a voluntary member of a group of friends, and as such is responsible for his or her own actions.
2. I acknowledge that my participation in club activities and use of club equipment involves risk of injury to my self and my personal property. I acknowledge that I am aware of the extent of the risks and have taken said risks into consideration in making my decision to participate. Furthermore, my participation in said activities is voluntary, I am acting as an individual, and I am assuming responsibility and liability for my own behavior and actions.
3. I hereby solely and expressly assume liability for all said risks and waive any claim I might have against the Milwaukee Adventure Club or any body or individuals acting in the capacity as agents of the club (committees, activity leaders, officers, etc). I assume full legal liability for my actions at club activities, and release the Milwaukee Adventure Club and any agent acting for the said club from any claims made as a result of my actions.
4. I hereby grant to The Milwaukee Adventure Club permission to use any photograph or audio or videotape taken at a Milwaukee Adventure Club activity and deemed by The Milwaukee Adventure Club to be in good taste, in any Milwaukee Adventure Club publicity, or other use specifically for the promotion of and public awareness of The Milwaukee Adventure Club.
5. This release shall be effective and binding upon the parties, as well as their heirs, beneficiaries, assigns, successors and legal representatives. By signing, I acknowledge having read and understood this release.
To be eligible for membership in the Milwaukee Adventure Club, I certify that I meet the following conditions.
1. I am 21 years of age or older
2. I am legally single, or was previously a member of Mile High Adventures.
3. I agree to abide by the rules of conduct.
4. I have signed this waiver on the line below.
Signature: _______________________
Date: _______________________
Please print this form, fill it out in its entirety, and mail it to the following address:
Peggy Schneider
Attn: Milwaukee Adventure Club - Waiver
7851 W. Heather Ave.
Milwaukee, WI 53223