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Family Name _________________________________ Phone
(_____) ______- _______
Address __________________________ Town
_______________ State ___ Zip _______
Email Address ________________________________________________
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Holder's First Name |
Last
Name
(if different from family name) |
Day |
Night
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Birthdate
Mo/Day/Yr |
Dues
See above |
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Family
Discount
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Deduct $20 ea. for the 3rd, 4th, 5th, etc. DAY
family member* age 6-69 |
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Total
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___Master Card
Card Number ______________________________ Exp Date _______________
___VISA ____Discover ___Amex
3 Digit Security code on back of card
______
Card
Holder Signature _________________________________________
I understand the operating schedule and
agree to abide by all club rules and regulations.
Head of Household Signature_____________________________________
Email Address _________________________________________
No refunds for any reason --- All pricing
subject to change without notice
* Family member as defined by IRS form 1040
* Family discounts valid for family members age 6-69
and not valid for Night Only memberships
Office Use Only: Transaction # ___________
Family Member # ______________
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If this is a gift,
fill out the following info and we'll send out a gift
certificate to you at the address you provide below:
Gift to: ________________________
From: _____________________________
Mail Gift Certificate
to:
Name _______________________________
Address _______________________________
City/Town ______________________________
State _________ Zip __________
I understand
that Skiing and Snowboard skiing are hazardous activities, and I accept and clearly
understand that there are inherent and other risks involved in the sport of skiing
for which this pass is to be used. Those risks include, but are not limited to
skier collision with padded and unpadded objects including natural and man-made
objects or other skiers, varying terrain, weather conditions, ice, maintenance
vehicles and many other hazards. I also understand that increased speed means
increased danger and risk of injury. As a condition of being permitted to use
the ski area premises, I freely accept and voluntarily ASSUME ALL THE RISKS of
any injury or property damage, COVENANTS NOT TO SUE and RELEASE The Springfield
Ski Club, Inc., its Board of Directors, employees and agents from any and all
liability for personal injury or property damage resulting from negligence, conditions
of the premises, operations of the ski area, actions or omissions employees or
agents of the ski area or from my participation in skiing at the area, accepting
myself the full responsibility for any and all such damage or injury of any kind
which may result. I further agree to HOLD HARMLESS AND INDEMNIFY the above named
persons or entity from any and all liability for death and/or personal injury,
medical or other expense or property damage to myself or others resulting in any
way from my use of the ski area premises. I further agree that (1) any claim,
which I may at any time bring for any reason against The Springfield Ski Club,
Inc., its Board of Directors, employees and agents, shall be submitted to the
jurisdiction of the State of Federal Courts of the Commonwealth of Massachusetts
and that no claims or actions shall be brought in any other jurisdiction; and
(2) any claim shall be governed by the law of Massachusetts. I HAVE CAREFULLY
READ THIS AGREEMENT, COVENANT NOT TO SUE AND RELEASE OF LIABILITY BETWEEN MYSELF
AND THE SPRINGFIELD SKI CLUB, INC., FULLY UNDERSTAND ITS CONTENT AND I SIGN IT
OF MY OWN FREE WILL. (If under the age of 18, must be signed by legal guardian).
X _____________________________date____________ If minors under
age 18 are listed on this application, please complete the following: By signing
this AGREEMENT, COVENANT NOT TO SUE AND RELEASE OF LIABILITY as Parent/Guardian
of , I am consenting to his/her skiing and/or snowboard skiing on the premises
of The Springfield Ski Club's Blandford Ski Area and I acknowledge and understand
that any and all risk, whether known or unknown, is expressly assumed by me and
all claims, whether known or unknown, are expressly waived in advance. Further,
I acknowledge and understand the terms and conditions of this Agreement, Covenant
Not to Sue and Release of Liability as noted herein and agree to be bound by those
terms and conditions. X_____________________________ date____________
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