Donor's Name _______________________________________ Tel. ( _____ )____________

Address __________________________________________________________________

City _______________________________________State________ ZIP_____________

____ AMEX ____ M/C ___ Discover ____ Visa

Card HolderCard Number _______________________________ Exp. Date ____________

Signature _________________________________________________________________

Email address _____________________________________________________________

The undersigned understands the operating schedule and agrees to abide by all club rules and regulations. (Safety Policy available at the Club Office & at skiblandford.org)

________________________________________
No refunds for any reason - Operating schedule and pricing subject to change without notice

>>> Please complete 2 pages <<<

For Benefactors and Corporate Sponsors - Please PRINT name as you wish it to be listed on permanent plaque

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OFFICE USE ONLY: TRANSACTION # __________ FAMILY MEMBER # ___________

Please read and sign below:

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___________________