Note that all required fields are marked with **
I hereby consent to the use of the personal information provided above for publication in the club membership directory and / or website. This information is intended for the sole use of club members.
In consideration of acceptance of this registration by the club, I HEREBY RELEASE, WAIVE AND FOREVER DISCHARGE the club and each of its members, officers and employees FROM ANY AND ALL claims, demands, damages, costs, expenses, actions and cause of action, whether in law or equity in respect of death, injury, loss or damage to myself or property, arising or to arise by reason of my participation in the club excluding any negligent act, whether by omission or commission of any of the aforesaid persons, parties or entities.
Please enter all team member names for choose your own leagues, each team member must submit their own form. Not on a team? Write assign for the other team members.
I hereby confirm that the information I have entered on this form is correct and true. I understand that if I have intentionally entered false information in this form to receive discounts that do not apply to me there will be a $25 administration charge on top of the outstanding membership dues owed.