Yankee Rowing Club
P.O. Box 3128, Amherst, MA 01004-3128
2017 Membership Application
Renewal ____ New Member ____
Name: _____________________________________
Home Address: _______________________ Mailing Address: ____________________________
_______________________________________________________________________________
Telephone:
Day ______________________________
Evening ___________________________________
E-Mail Address: __________________________________________________________________
In case of emergency, contact:
1) ______________________________
2) _________________________________________
Telephone ________________________
Telephone___________________________________
Membership Information
Member USRowing: ____No ____Yes, Number ______________
Rowing Experience: ___________________ (Number of years, sweep, single, etc.)
Sculling Level: ____Recreational ____Novice ____ Intermediate ____ Race ____
Swimming Requirement- ability to swim competently a minimum of 100 yards
unassisted and stay afloat for 10 minutes- Member's initials:___
Membership Dues & Fees
Membership: $490/year ($350 after July 16, $235 after Sept. 1)
Rack Space: $415/year, $40/month (limited availability)
Membership term is January to December. Send applications and dues to:
Yankee Rowing Club
P.O. Box 3128, Amherst, MA 01004-3128
Release
I assume all risks by my participation and will not hold Yankee Rowing Club responsible. I agree
to uphold and abide by all rules and regulations of Yankee Rowing Club.
Signed: __________________________
Date: _________________
If under 18 years of age, signature of parent or legal guardian is required:
Signed: __________________________
Date: _________________
Please complete USRowing Release of Liability Form on the reverse side
ReleaseofLiability
INCONSIDERATIONofbeinggiventheopportunitytoparticipatein
anyUSRowingactivity,includingscheduled,supervisedclubactivities,
andregisteredregattas,duringthepolicyterm12/31/16-12/31/17,I,
formyself,mypersonalrepresentatives,assigns,heirs,andnextofkin.
1.IACKNOWLEDGE,agreeandrepresentthatIunderstandthenature
ofRowingActivities,bothonwaterandlandbased,andthatIam
qualified,ingoodhealth,andinproperphysicalconditionto
participateinsuchActivity.
2.IFULLYUNDERSTANDthat:(a.)ROWINGACTIVITIESINVOLVERISKS
ANDDANGERSofseriousbodilyinjury,includingpermanentdisability,
paralysisanddeath("Risks"};(b.)theseRisksanddangersmaybe
causedbymyownactions,orinactions,theactionsorinactionsof
othersparticipatingintheActivity,theconditioninwhichtheActivity
takesplace,orthenegligenceoftheReleasenamedbelow;(c.)there
maybeotherrisksandsocialandeconomiclosseseithernotknownto
meornotreadilyforeseeableatthistime;andIFULLYACCEPTAND
ASSUMEALLSUCHRISKSANDALLRESPONSIBILITYFORLOSSES,COSTS,
ANDDAMAGESIincurasaresultofmyparticipationintheActivity.
3.IAGREEANDWARRANTthatIwillexamineandinspecteachActivity
inwhichItakepartasamemberofUSRowingandthat,ifIobserve
anyconditionwhichIconsidertobeunacceptablyhazardousor
dangerous.IwillnotifytheproperauthorityinchargeoftheActivity
andwillrefusetotakepartintheActivityuntiltheconditionhasbeen
correctedtomysatisfaction.
4.IHEREBYRELEASE,discharge,andcovenantnottosueUSRowing,
theClub,theRegatta,theiradministrators,directors,agents,officers,
volunteersandemployees,otherparticipatingregattaorganizers,any
sponsors,advertisers,andifapplicable,ownersandlessorsof
premises,onwhichtheActivitytakesplace,(eachconsideredoneof
theReleaseesherein)fromallliability,claims,demands,lossesor
damagesonmyaccountcausedorallegedtobecausedinwholeorin
partbythenegligenceoftheReleaseorotherwise,includingnegligent
rescueoperations;andIfurtheragreethatif,despitethisreleaseand
waiverofliability,assumptionofrisk,andindemnityagreement,I,or
anyoneonmybehalf,makesaclaimagainstanyoftheReleasees.I
WILLINDEMNIFY,SAVEANDHOLDHARMLESSeachoftheReleasees
fromanylitigationexpenses,attorneyfees,loss,liability,damage,or
costwhichanymayincurasaresultofsuchclaim,tothefullestextent
permittedbylaw.
ToapplyforUSRowingmembership:YankeeRowing
ClubUSRowing#487--athletecodeL6NCD
Ihavereadthisagreement,fullyunderstanditsterms,understandthat
Ihavegivenupsubstantialrightsbysigningitandhavesigneditfreely
andwithoutanyinducementorassuranceofanynatureandintendit
tobeacompleteandunconditionalreleaseofallliabilitytothe
greatestextentallowedbylawandagreethatifanyportionofthis
agreementisheldtobeinvalid,thebalance,notwithstanding,shall
continueinfullforceandeffect.
PrintedNameofParticipant:
_____________________________________________________
USRowing#_______________DateofBirth:_________________
Address:______________________________________________
City:_________________________State:______Zip:_________
Phone:_______________________Date:___________________
Participant’sSignature:__________________________________
Organization:YankeeRowingClub PARENTALCONSENT
(ifparticipantisundertheageof18).
ANDI,theminor'sparentand/orlegalguardian,understandthe
natureofrowingactivitiesandtheminor'sexperienceandcapabilities
andbelievetheminortobequalifiedtoparticipateinsuchactivity.I
herebyrelease,discharge,covenantnottosue,andAGREETO
INDEMNIFYANDSAVEANDHOLDHARMLESSeachoftheReleasees
fromallliability,claims,demands,losses,ordamagesontheminor's
accountcausedorallegedtobecausedinwholeorpartbythe
negligenceoftheReleaseesorotherwise,includingnegligentrescue
operations,andfurtheragreethatif,despitethisrelease,I,theminor,
oranyoneontheminor'sbehalfmakesaclaimagainstanyofthe
aboveReleasee,IWILLINDEMNIFY,SAVE,ANDHOLDHARMLESSeach
oftheReleaseesfromanylitigationexpenses,attorneyfees,loss,
liability,damage,orcostanymayincurastheresultofanysuchclaim,
tothefullestextentpermittedbylaw.
PrintedNameofParent/Guardian:
_____________________________________________________
Address:______________________________________________
City:_________________________State:_____Zip:__________
Phone:_______________________Date:___________________
Parent/GuardianSignature(onlyifparticipantisundertheageof18):
_________________________________________