Upper Bucks Ski Club
Founded 1974
PO Box 271, Perkasie PA 18944
Member, Eastern Pennsylvania Ski Council Member, Northeast Ski Council
Trip Destination: Mount Snow, Vermont
Trip Dates: February 8 – 10, 2008
Application for: Self___________ Family___________
Name:________________________________________________________________
Address:______________________________________________________________
Phone: Home________________Work___________________Cell ______________
Current Yr Club Membership: UBSC Member________UBSC Applicant__________
Person to Notify in Case of Emergency:
Name:__________________________________Relationship:___________________
Address:______________________________________________________________
Phone: Home__________________________Work___________________________
Cancellation: No refund is guaranteed. Applicants may purchase trip insurance from a travel agent.
Release & Waiver of Liability: I agree and understand that Upper Bucks Ski Club (UBSC) and its members are not responsible for my safety or the safety of my family on this trip. I/We release UBSC and its members from any liability for personal injuries, death or property damage in connection with this trip. I accept personal responsibility for my/our actions and any damage that I/we may cause to other persons or properties. I/We are voluntarily participating in this trip at my/our own risk. I/We have read, understand and agree to the above statements.
Signature (Adult Family Member(s))
_________________________________________ Date__________________
_________________________________________ Date__________________
Family Members Participating in Trip:
_________________________________________ Date__________________
_________________________________________ Date__________________
Date_____/_____/________
Participant(s):______________________________________________________(print)
Liability Release and Indemnity Agreement
I acknowledge that skiing, ski racing and related activities are HAZARDOUS activities and that I have made a voluntary choice to participate in those activities despite the risks that they present. In consideration of my being permitted to participate in the event named on this form, I agree to ASSUME ANY AND ALL RISKS OF INJURY OR DEATH which might be associated with or result from my participation in this event.
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I further agree to RELEASE FROM LIABILITY and to INDEMNIFY AND HOLD HARMLESS the organizers and sponsors of this event, Upper Bucks Ski Club and Eastern Pennsylvania Ski Council, it’s officers, board members or volunteer supporters for any damage, injury, or death to myself or to any person or property, whether caused by their NEGLIGENCE or for any other reason, in any way connected with my preparation or practice for or participation in these skiing events.
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Cancellation and Refund Policy
Some restrictions and penalties apply to your vacation investment. If you cancel your reservation, YOUR RIGHT TO A REFUND IS LIMITED. NO REFUND IS GUARANTEED. Expenditures, which can be recaptured by Upper Bucks Ski Club, less $25 handling charge may be refunded. January 20, 2008 and thereafter, refund obtained ONLY if replacement is found. Trip cancellation insurance can be purchased via travel agencies and is recommended.
No refunds for early departure or late arrival. No shows, no refund. No partial refunds will be made on unused portions of this package.
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