Form C Trails Club Olympic National Park Participant Application

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10/19/2012, Form C
TRAILS CLUB OLYMPIC NATIONAL PARK PARTICIPANT APPLICATION
NOTE: The Trails Club is not responsible for providing or arranging your outing transportation to or from
Naturebridge at Lake Crescent. By applying for this outing, you agree to stay with the group and comply
with the direction of outing and hike leaders.
Please print your answers clearly.
Membership Status (select one): Club Member
FWOC Member
Non-Member
Applicant Name: _______________________________________________________________________
Street Address: ________________________________________________________________________
City/State/ZIP: _________________________________________________________________________
Home Phone: ______________________Work: _______________________Cell:____________________
E-Mail:____________________________________________________ DOB: ______________________
Experience as relates to this outing: Please list training and experience such as other outings attended
current fitness program, etc. Attach an additional page if necessary.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Any medical or physical condition the leader should be aware of: ________________________________
_____________________________________________________________________________________
Have you passed a recent First Aid Class? _____ When? ________ CPR Class?____ When? ___________
RECOGNITION OF RISKS
The Trails Club of Oregon was organized in 1915 and currently promotes the enjoyment of outdoor activities such as
trail hiking, mountain and rock climbing, skiing, cycling, swimming, camping, and other similar activities involving the
out-of-doors. While the club has had an excellent safety record, it is the responsibility of the Trails Club of Oregon to
inform you that these activities, although peaceful in nature, can be dangerous and as such can cause severe injury
and even death due to conditions and forces which we cannot predict. Having made you aware of these facts, the
Trails Club of Oregon believes you must make your own decision regarding participation in these activities.
DECLARATION OF INTENT
I acknowledge that the Trails Club of Oregon has apprised me of the dangers and hazards, hidden or apparent, in
the various activities it sponsors, as outlined above, and I elect to accept such risks and undertake these activities on
my own responsibility. My signature below signifies I hereby, for myself, my heirs, and personal representatives,
release and forever discharge the Trails Club of Oregon and its elected officers from any claims or demands for
resultant injuries or even death, sustained by me, while participating in a Club sponsored event. Furthermore, I am
financially responsible for the costs of any medical treatment or evacuations, requested by me or others on my
behalf, should I become seriously ill or injured.
Signature of applicant ___________________________________Date ________________
Signature of parent or guardian if applicant is under 18 _________________Date ________

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