NENSA Club Affiliation*: ___________________________________________________________
* All NE BKL Clubs are NENSA Clubs
Additional BKL-age Family Members
(Who want to become New England BKL members and share the same
address.)
Name: ________________________ Date
of Birth: _____________Gender:_____ NENSA # _____
Name: ________________________ Date
of Birth: _____________Gender:_____ NENSA # _____
Name: ________________________ Date
of Birth: _____________Gender:_____ NENSA # _____
•••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• Dues Worksheet
Individual New England BKL Members ............. (number) ____@
$20 each = $_________
TOTAL DUES $_________ * Please return this BKL Membership
Application form and check to your BKL Club leader. OR
* Individuals may send BKL Membership Application
form and check to:
NENSA
PO Box 99, Westford, VT 05494
* By joining the New England BKL, you have
also joined NENSA – no further dues are necessary.
* For family members age 14 or older as of January 1st of the
ski season, the NENSA Membership Application form may be accessed
through the website, www.NENSA.net.
* The Parent/Guardian who is signing up a BKL member must list
each member and sign the Waiver and Release below.
NEW ENGLAND NORDIC SKI ASSOCIATION
WAIVER AND RELEASE OF LIABILITY
In consideration for the rights and privileges associated with membership
in the New England Nordic Ski Association, I acknowledge and agree
to be bound by the following:
1. Identification of Risks. I understand that participation in any
skiing activity, including but not limited to, preparation for,
participation in, and coaching of activities in cross-country ski
competitions and clinics, involve risk of serious injury, including
permanent disability, death and other losses, due to inactions or
negligence of myself or others.
2. Assumption of the Risk. I agree that I am responsible for my
safety while participating in activities associated with NENSA,
and that such responsibility includes participation only a) when
I am both physically and psychologically prepared to participate
safely, b) after fully familiarizing myself with the venue before
beginning the activity, and c) while using the equipment of a type
and condition reasonably necessary to safely participate. I assume
all risk connected with responsibility for any injury or loss connected
with my participation.
3. Waiver. Aware of the risks and willing to assume them, I hereby
release and agree to hold harmless the New England Nordic Ski Association
(NENSA), its officers, directors, employees, agents, coaches, trainers,
doctors, officials, volunteers, affiliates, event organizers, sponsors,
owners of property and trails used by me (Released Parties) from
loss, injury, or death to myself or to any other person, or other
damage to person or property resulting from my participation in
events and competition and any related activities including, without
limitation activities in connection with sponsorship, organization
or execution of any event and travel to and from such event, whether
I may participate as an athlete, coach, volunteer, spectator, or
in any other manner associated with NENSA. This release is intended
as a waiver of any claim I may have whether based upon negligence,
breach of warranty, contract or other legal theory, against any
of the above Released Parties, accepting myself the full responsibility
for any such
loss, injury, death or damage which may result. I intend for this
release to also apply to my relatives, personal representatives,
heirs, beneficiaries, next of kin, and assigns. If any part of this
agreement is determined to be unenforceable, all other parts shall
be given full force and effect. This waiver does not release acts
of gross negligence or willful and wanton misconduct of any party.
4. Insurance. I currently have, and agree to maintain throughout
the time that I train and compete, valid and sufficient medical
and accident insurance. I understand that this is my sole responsibility
and release all persons and entities from providing this coverage
for me.
For Athletes of Minor Age - This form will not be processed without
parent/guardian signature.
This is to certify that, as parent/legal guardian of this/these
minor(s) named below I do hereby acknowledge and consent to his/her
agreement to be bound by each of the terms and conditions above.