Bend Adventure Racing Klub (BARK) Membership Application

Last Name___________________________    First Name____________________________

Street Address_________________________________________________________________

City_______________________________  State_____________  Zip____________________

Phone(home) _______/_______-________ Phone(work)________/_______-________

E-mail ______________________________

Are you willing to have your name, address, phone number and e-mail address published in the annual BARK membership list? ______ Yes   ______ No

Activities I am interested in (circle any):

     Group Training        Clinics        Racing        Race Support        Race Organization

Trekking        Orienteering        Mountain Biking        Paddling        Ropes

     Snowshoeing       X-C Skiing      Nighttime Training      Newsletter    Leading Outings

Other_________________________________________

BARK Membership Annual Dues :  $15

Return to:                     Bend Adventure Racing Klub

501 NW Riverfront

Bend, Oregon 97701

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 THE 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.