LANCASTER

Name(s):___________________________________________________________Date:____________________________________
Address: ____________________________________________________________________________________________________
Phone Number: _____________________________________________________________________________________________
Email Address:__________________________________________________________________(for newsletter and updates)

Amt Enclosed: $__________ (make check payable to The Lancaster Hiking Club)  

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CONSENT & RELEASE FROM LIABILITY / WAIVER & DISCLAIMER

Participation in The Lancaster Hiking Club is voluntary and at YOUR OWN RISK. Hiking, exercising, and related activities can involve certain health and medical risks not limited to injury, exposure to extreme weather conditions, broken bones, lacerations, permanent paralysis and death. By signing this consent, Release from Liability and Indemnity Agreement, I release The Lancaster Hiking Club, hike leaders, members, officers, as well as the local and state jurisdictions and their employees from any liability and responsibility for any harm, injuries or death that may result from participation in such programs and activities. The Lancaster Hiking Club, hike leaders, members and officers WILL NOT be liable or responsible for harm to others and property damage resulting from participation in such programs and activities.

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It is advised to check with your physician before starting any exercise program.

Please consult with an attorney if you have any questions regarding this document.

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By signing this agreement, I ­­­_____________________________________have read and understand the inherent risks of this activity and agree to release The Lancaster Hiking Club , hike leaders, members, officers and assignees from any liability for any injuries, death or property damage that may result from my participation.

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Signature of Participant/Member: 16-years of age and over

X______________________________________________________________________Date:____________________
 

 Signature of Parent or Legal Guardian if Participant/Member is a minor under the age of 18:
 

X______________________________________________________________________Date:____________________

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MAIL CHECK TO:

LANCASTER HIKING CLUB

P.O. BOX 7922

LANCASTER, PA  17604-7922

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