Release and Indemnification Agreement
Whereas, the person named on this registration form desires to
participate in the Hiking Award Program coordinated by the
Washington/Ozaukee County Chapter of the Ice Age Trail
Alliance, and whereas the Alliance and its officers and directors, Program sponsors, volunteers and chapter officers and
members (collectively, “the Alliance”), desire to ensure that, to
the extent possible within the law, they will not be sued or held
liable for any injuries or damages sustained by participants in
this Program.
Now therefore, I sign this Release and Indemnification Agreement on my behalf, and on behalf of anyone else who would
be able to sue if I were injured while participating in this Program.
I agree and acknowledge as follows: (1) Participation carries
with it some risk of serious injury. The risks include but are not
limited to those caused by overexertion, vehicular traffic,
weather, facilities, equipment, the Alliance and other participants; (2) I assume all risks of participating in this Program; (3) I
understand the Alliance is relying upon the agreements and
representations I make on this form; (4) I release the Alliance
from any and all claims, including negligence claims and
claims relating to personal injury or property damage arising
out of my participation in this Program, except that I do not
release any reckless negligence or intentional tort claims; (5) I
agree to indemnify the Alliance if I or anyone else brings a
claim against the Alliance for injuries I receive due to my participating in this Program (“indemnify” means to reimburse the
Alliance for any amounts they may have to pay and expenses/fees they may incur due to any injury or claim relating to
me); (6) I have read this document and understand it.
If I am under age 18, my parent or guardian is signing on my
behalf, and my parent or guardian agrees to indemnify the
Alliance if I or anyone else brings a claim against the Alliance
due to injuries I received due to my participating in this Program. With knowledge of the risks involved, I waive the rights I
might otherwise have, and I freely sign this Agreement.
DATE SIGNED: _________________________________
PARTICIPANT’S SIGNATURE:
___________________________________________
PARENT’S/GUARDIAN’S SIGNATURE:
___________________________________________
Highlights of the Washington
County Segments of the Ice
Age National Scenic Trail
Wildlife. Wildflowers. Solitude. Pristine glacial topography. Scenic panoramas. Awe-inspiring beauty.
Located along the intersection of the Green Bay and
Lake Michigan Lobes of the Wisconsin Glaciation of
the last Ice Age, the Washington County “midmoraine” segments of the Ice Age National Scenic
Trail provide excellent views of kettles, moraines,
kames, eskers, drumlins and other glacially created
features.
Trail segments are easy to access from the several
trailheads. Beginning at the Northern Kettle Moraine
State Forest, as you meander along the footpaths,
you’ll traverse tranquil forests and prairies, walk
through Ridge Run County Park, stroll through the
“Polk Kames,” amble across Pike Lake State Park,
pass around the Holy Hill Shrine and Basilica, and
hike into the Loew Lake State Forest. Details regarding the trail features and amenities along the trail
will be provided to registrants of the “Meander the
Mid-Moraine” Hiking Award Program.
On the trail you’ll enjoy the sense of being alone in
the wilderness, while never being far from access
roads, and dining, camping and lodging facilities.
Visit: www.iceagetrail.org for information about joining the IATA, its many chapters, and the Ice Age
National Scenic Trail.
For more information about the “Meander the MidMoraine” Hiking Award Program, contact:
Washington/Ozaukee County Chapter — IATA
Hiking Award Program Coordinator
9857 W. Menomonee Park Court #7
Milwaukee, WI 53225
e-mail: [email protected]
The Ice Age Trail
Let it shape you.
“Meander the
Mid-Moraine”
Ice Age Trail
Hiking Award Program
Washington/Ozaukee
County Chapter — Ice
Age Trail Alliance
Earn an Award for
Hiking the Entire Ice
Age Trail in
Washington County.
HIKING LOG FOR THE ICE AGE TRAIL
SEGMENTS IN WASHINGTON COUNTY
Segment
(from North to South)
Miles
Date
Completed
*
1
Milwaukee River
E. Kettle Moraine Drive to
Eisenbahn Trail
7.2
2
Kewaskum
Eisenbahn Trail to CTH-D
(w/ 2.2 mile road connect)
5.5
3
West Bend
CTH-D to Paradise Drive
7.0
4
Cedar Lakes
Paradise Drive to Cedar Creek Rd.
(w/ 5.5 mile road connect)
The Ice Age Trail:
Let it shape you!
Challenge yourself to hike
the approximately 45
miles of the Ice Age Trail
in Washington County.
The Washington/Ozaukee
“Meander the Mid-Moraine” to recognize
7.7
Here’s how the program works:
1.
tration fee to the address shown. Retain
6
Pike Lake
STH-60 to CTH-E
(w/ 0.3 mile road connect)
3.2
7
Holy Hill
CTH-E to Donegal Road
(w/ 0.5 mile road connect)
the Hiking Log.
2.
The IATA chapter will send you maps of
the Washington County trail segments and
related information for hiking the trail.
3.
4.
8
7.0
Loew Lake
Donegal Road to CTH-Q
(w/ 1.1 mile road connect)
6.1
Total
45.8
PLEASE COMMENT ON YOUR HIKES:
to the chapter at the address shown.
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
Program Register, and send you an award
patch and a Certificate of Completion.
$ 6.00
but must hike with the Ice Age Trail Alliance member
or non-member who has registered for the “Meander
the Mid-Moraine” Hiking Award Program.
____________________________________
First Name
Last Name
Address
City
State
Zip
(required for efficient / low cost communications)
____________________________________
Here’s what you receive from the IATA chapter for the
“Meander the Mid-Moraine” Hiking Award Program:

Maps of the Washington County Ice Age Trail segments

Local information regarding each segment map

How to obtain the most recent trail condition reports

An attractive patch acknowledging your achievement,
to sew onto your backpack, vest or hat
Washington/Ozaukee Co. Chapter, IATA
Hiking Award Program Coordinator
ment, and mail the completed Hiking Log
“Meander the Mid-Moraine” Hiking Award
Companion to above *
Phone (optional)
Record the dates that you hike each seg-
The chapter will record your name in the
$12.00
A companion can also be eligible for an award,
E-mail
Complete both sides of the registration
form, detach it and send it with the regis-
Non-member
____________________________________
2.1
individual’s hiking achievements.
$10.00
____________________________________
Slinger
Cedar Creek Road to STH-60
(w/ 0.6 mile road connect)
5
Ice Age Trail Alliance Member
____________________________________
County chapter of the Ice Age Trail Alliance
has developed a reward program entitled
REGISTRATION FORM
(Last revised: 9/23/14
9857 W. Menomonee Park Court #7
Milwaukee, WI 53225
Make checks payable to:
Washington/Ozaukee County Chapter, IATA
(Be sure to read and sign waiver on reverse side.)