Piccadilly Ski Club

APPLICATION FOR MEMBERSHIP

 

YEAR 2007/2008

 

NAME ___________________________________________________________ BIRTHDAY ____/____/____

 

ADDRESS ____________________________________ E-MAIL ____________________________________

 

CITY ________________________________________ STATE __________________ ZIP _______________

 

HOME PHONE ( ____ ) __________________ WORK PHONE ( ____ ) __________________ EXT _______

 

EMPLOYER __________________________________ OCCUPATION ______________________________

 

MALE      _____ SINGLE      _____

FEMALE  _____ MARRIED  _____  SPOUSE NAME ____________________________________________

 

IN CASE OF EMERGENCY/INJURY ON A TRIP, PLEASE CONTACT

 

1st) NAME _____________________________________________    PHONE ( ____ ) ___________________

 

RELATIONSHIP ________________________________________

 

2nd) NAME _____________________________________________    PHONE ( ____ ) ___________________

 

RELATIONSHIP ________________________________________

Check here if you wish to be excluded from the printed and electronic roster _____

WAIVER OF LIABILITY

 

PICCADILLY SKI CLUB, INC.(the “Club”) and for its officers and members shall not be held responsible or liable for any injury, damage, or loss occasioned by neglect or default of any company or person engaged in conveying any tours or trips whether by railroad, motor bus, motor car, steamship, boat, air or any other means (as such are not responsible) or for any damage, expenses or inconveniences caused by late train, plane, motor bus, motor car, or ship arrivals and departures or by any change of schedule or other conditions.  The Club shall not be liable or accountable for damages, loss, or injury occasioned by any hotel proprietor or car rental organization or other persons supplying services or materials in connection with Club activities. The Club reserves the right to withdraw a tour or trip, to refuse to accept or retain any person as a member of a tour or trip at any time, or to make changes in the published itinerary, whenever, in its sole judgment, conditions warrant, or if it deems it necessary for the comfort, convenience or safety of the (passengers) participants.  The Club is not to be held responsible for lack of snow, non-operation of lifts at ski resorts, (e) non-availability of equipment, lost, stolen or damaged property, or for closure of access routes to or from resorts due to snow or other weather conditions; nor is it to be held liable for any additional expenses or consequences arriving therefrom.  The Club shall not be held liable for any payment of any refund for unusual hotel accommodations or meals occasioned by late(r) arrivals(,) or the hotel holding rooms as per confirmed itineraries. Piccadilly Ski Club, Inc. shall not be held responsible or liable for any injury due to accidents of any nature at any time during a trip or other official Club function.

 

I have read, understand and agree to the above:

 

SIGNATURE __________________________________________________________ DATE ____/____/____

 

Membership dues and contributions to Piccadilly Ski Club are not tax deductible as charitable contributions for federal income tax purposes.

_________________________________________________________

Membership Fee      Date Paid      Check #      Pinned      Date Received

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