Benscreek Canoe Club Membership Application 2022

Benscreek Canoe Club

Membership Application 2022

Please complete online or print and mail to: Richard Bloom, 1181 Colver Rd, Ebensburg, PA 15931 . If paying by mail, make checks out to: Benscreek Canoe Club

Membership:

Renewal New member

First Name *

Last Name *

Street Address *

City *

State *

Zip *

Phone number *

Cell phone

Member since:

Family Members:

E-mail *

Please give us some information on your boating skills and interests. Please indicate the type of boat that you paddle and the maximum difficulty with which you are comfortable.

What type of boat do you typically paddle? Check all that apply.

flatwater canoe whitewater canoe recreational kayak whitewater kayak SUP Raft or Shredder

What is the maximum difficulty of the rivers that you typically paddle?

Flatwater Class I Class II Class III Class IV Class V

Please check the rivers or lakes that you often paddle. Check all that apply.

Stonycreek Canyon Lower Stonycreek Flatwater Sections of the Stonycreek Lower Yough Middle Yough Juniata Susquehanna Quemahoning Reservoir or other local lakes

Please indicate other interests. Check all that apply.

Canoe camping Canoe or Kayak Racing Hiking Cross Country Skiing Downhill Skiing Mountain Biking Road Biking Rails to Trails Biking Climbing

Do you wish to be included in our online roster? Please answer "yes" or "no" *

Annual dues are $15 for individuals or families (a great deal). Please consider giving the club a donation to help us pay for regular Whitewater Releases from Quemahoning Reservoir.

Donation:

MEMBER’S MUTUAL AGREEMENT FOR PROTECTION FROM LIABILITY DESIRING TO JOIN MY FELLOW PADDLERS IN THE BENSCREEK CANOE CLUB (BCC), I HEREBY DECLARE THAT I FULLY UNDERSTAND THE FOLLOWING FACTS OF LIFE ON THE RIVER: (1) Canoeing, Kayaking, or Rafting, particularly on whitewater rivers, is inherently hazardous and therein lies some of its appeal for me. (2) No one but myself is responsible for my safety when I choose to challenge my capabilities by running a particular river. (3) It is my moral and sporting “duty” to assist my fellow paddlers to the best of my own personal skill and ability if they appear to need such assistance-but only so long as I can do so, and in my own best judgment, without significant danger to myself. I further understand that does not imply a LEGAL duty for me to do so, nor for anyone else to render me such assistance. NOW THEREFORE, INTENDING TO BE LEGALLY BOUND, I HEREBY DO WAIVE, for myself, my heirs and assigns, and for anyone else whomsoever claiming through me, my right to sue or in any other way to attempt to hold responsible, BCC, its officers or so called “trip leaders”, or any of my fellow paddlers, for any mishaps to my person, or my equipment, other than that which is due to the willful and malicious actions of the individual whom I claim relief. This waiver is given in the interest of permitting the BCC to exist and serve the paddling community, and to enable myself and my fellow paddlers to feel free to donate their services to improving the sport and to help in training those less skilled without fear of liability. MY WAIVER, THEREFORE, IS GIVEN IN CONSIDERATION FOR SIMILAR WAIVERS TO BE GRANTED ON MY BEHALF BY ALL MEMBERS OF THIS ORGANIZATION.

Today's Date:

Date

Signed by:

Total: 1 year membership plus donation. $15 minimum

USD Membership

Please Run the Wizard