The Wild SnowBerry

a fun winter adventure

Saturday February 24   *   9am   *   at a local Sno-Park

 

Registration Form

 

Team Name____________________________________________

 

Team Captain:

Last Name_________________________    First Name__________________________

Address__________________________________________________________

City____________________  State_____________  Zip___________________

Phone _______/_______-________

E-mail _______________________

 

Team members:

Last Name___________________________    First Name__________________________

Last Name___________________________    First Name__________________________

Last Name__________________________    First Name__________________________

 

Each member must read and sign waiver:

Assumption of Risk and Liability Waiver

Outdoor adventures by their very nature are inherently dangerous and involve some degree of risk. I am aware that participating in any Bend Adventure Racing Klub outings may expose me to certain risks and dangers including, but not limited to the hazards of mountainous, aquatic, or wilderness terrain, accident, illness, the forces of nature, and travel to and from the trailhead or point of departure. I am aware that it is not possible to foresee all of the potential hazards of outdoor activities. Each participant in a BARK activity is responsible for his or her decisions. To the best of my knowledge, I feel physically and mentally able to assume full participation in the activities in which I will participate. I understand that BARK is a volunteer organization. In consideration of voluntarily participating in these outings, trips, or activities, I have and do hereby assume all the risks inherent in these activities and hold harmless the Bend Adventure Racing Klub and its agents, tour leaders, officers, and instructors, from and against any and all claims, liability, and demands of any nature, for the acts or omissions of the Bend Adventure Racing Klub or its agents, tour leaders, officers, or instructors.

 

I HAVE READ AND UNDERSTAND THE ABOVE STATEMENTS CONCERNING  BEND ADVENTURE RACING KLUB.

 

Each member must sign the BARK Liability Waiver. A parent or guardian must sign the form for members under 18 years of age.

 

Signature: _______________________________________ Date: __________________

Signature: _______________________________________ Date: __________________

Signature: _______________________________________ Date: __________________

Signature: _______________________________________ Date: __________________

 

Return to:

BARK- The Wild SnowBerry II

501 NW Riverfront

Bend, Oregon 97701

(541) 389-5599

pam_stevenson@hotmail.com