FDSC ADULT LESSON PROGRAM REGISTRATION
(Please Print)

Membership #__________                              New Member___________

Name______________________________________________________________________
             (Last)                                                                            (First)

Address____________________________________________________________________

E-Mail______________________________      Phone  (home)________________   (work)________________

Class Level:
     A _____ Level _____
     B _____ Level _____
     C _____ Level _____
     D _____ Level _____
FDSC Tests Passed:
     Basic _________
     Standard ______
     Advanced ______

 
   
Specialty Class:
     Race Training ______
     Snowboarding ______
     Bump Clinic ________		 Have you previously taken lessons from our Ski School?      Yes ____  No____
   
Cost:  $15.00 (Non-Refundable) Paid by:
Accepted by: _______________________ Check #______________  Cash_____

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Release and Indemnification Agreement (Please Read Carefully)

I understand that the Flying Dutchmen Ski Club, Inc. (the “Club”) is a year round skiing, sports and social club which sponsors a variety of activities, including skiing, for the benefit of its members.  I am aware that many of the Club’s activities, including skiing, are inherently dangerous activities, which involve the risk of serious injury or even death.  I agree that by participating in any Club related activity, that I alone am responsible for my safety and agree that I alone assume the risks involved in any such activity.

In addition, and to the fullest extent allowed by law, I agree that I will not institute any law suit or other legal action against the Club, its members, officers, directors, delegates, instructors, agents employees, representative, servants or assigns as a result of my participation or injury at any Club related activity.  Nor will I voluntarily assist anyone else in the pursuit of any such law suit or other legal action.

I also agree to indemnify and hold harmless the Club, its members, officers, directors, delegates, instructors, agents, employees, representatives, servants or assigns from and against any and all claims, actions, suits, judgements, damages, and costs, including reasonable attorneys fees, that may result by reason of any suit or other legal action that I either commence or assist with as described in the preceding paragraph.  This Release and Indemnification Agreement shall bind me, my distributees, heirs, executors, representatives, successors and assigns.

I understand and acknowledge that the Club is acting in reliance upon the agreements made by me in the Release and Indemnification Agreement in order to extend to me the benefits of membership in the Club and were I not willing to abide by the terms of this document, such membership and opportunity to participate in Club related activities would not be extended to me.

 

Signed_____________________________________              Date___________________________