Scarborough Cross Country Ski Club
Membership Application & Renewal Form


NAME: ____________________________________

Date of Birth


CITY: __________________PROV. _______ POSTAL CODE: ____________

PHONE:(~-~)___________________ E-MAIL:

Membership Fees for the Club Year November 1 to October 31 are $25.00

Renewing Member D
New Applicant o

Membership requirements:

Membership Application (completion of this form)

Cheque for $25.00 Cheque# __________ Cheque Date: ______

Cross Country Canada-SIGNED "Informed Consent & Assumption of Risk Agreement"


Release: Membership will not be accepted unless signed
In making application to participate in activities of the Scarborough Cross Country Ski Club, 1/we affirm to be in good
health, capable of the required effort needed to participate in club activities and accept as my/our personal risk the hazards
of such participation. 1/we release the Scarborough Cross Country Ski Club, its executives, directors, instructors, trip
organizers and trip leaders from any liability whatsoever for loss, damage or injury (including death) howsoever caused
which may result from my/our participation in any activity organized by the club. 1/we declare that the Release is binding
upon my/our heirs, executors, administrators and assigns. 1/we the undersigned have read and understand the Release
and agree that participation in club activities is entirely at my/our own risk.

Signature of applicant
Signature of witness (not family member) Date

How did you hear about the Scarborough Cross Country Ski Club?
Word-of-mouth D Brochure D Website D Publication D Other D (please specify below)

In case of accident please notify:
Name: Phone:

Mail Membership Application & Cheque to:
Scarborough Cross Country Ski Club
111 Milford Haven Drive  .Scarborough Ont. M1G 3C9




This is a binding legal agreement. As a Participant in the sport of cross-country
skiing and the programs, activities and events of Cross Country Canada and Canadian
Snowsports Association (hereinafter called "CCC/CSA") , Southern Ontario District
Ski Division (hereinafter called the "Division") and Scarborough Cross Country Ski
Club (hereinafter called the "Club") which include without limitation cross-country
skiing competitions, camps, clinics, and related activities such as roller-skiing,
road cycling, running and hiking (hereinafter called the "Activities"), the
Participant and/or the Parent/Guardian of the Participant (hereinafter called the
"Parties") acknowledge and agree to the following terms:
Description of Risks

The Participant is participating voluntarily in the Activities. In consideration
of the Participant's participation in the Activities sanctioned by one or more of
CCC/CSA, the Division and the Club, the Parties hereby acknowledge that they are
aware of the risks, dangers and hazards associated with or related to the
Activities, and may be exposed to such risks, dangers and hazards. The risks,
dangers and hazards include, but are not limited to, injuries from:
a) training whether indoor or outdoor including strength training, running,
hiking and cycling;
b) overusing, exerting and stretching various muscle groups and strenuous

cardiovascular workouts;
c) vigorous physical exertion, rapid movements and quick turns and stops;
d) falling to the ground due to slips, trips or uneven, slippery or irregular

terrain or surfaces;
e) contact, colliding or being struck by skis, ski poles, equipment, trees,
other individuals or other fixed objects;
f) failing to participate within one's abilities, skill and within designated

g) becoming lost or separated from the group or the group becoming split up;
h) failure to properly use any piece of equipment or from the mechanical

failure of any piece of equipment;
i) extreme weather conditions which may result in frostbite, hypothermia,

snowstorms, sunstroke or lightning strikes;
j) encounters with animals or plants including allergic reactions;
k) travel to and from training, competitive events and associated

non-competitive events which are an integral part of the Activities; and
1) other risks normally associated with participation in the Activities.

Furthermore, the Parties are aware:
a) that injuries sustained may be severe, paralyzing or fatal;
b) that the Participant may experience anxiety or embarrassment while
challenging themselves during the activities, events and programs of
CCC/CSA, the Division and the Club;
c) that the risk of injury is reduced if the Participant follows all rules
established for participation; and
d) that the risk of injury increases as the Participant becomes fatigued.


In consideration of CCC/CSA, the Division and the Club accepting the Participant's
application for membership in the Club or allowing the Participant to participate,
the Parties agree that CCC/CSA, the Division and the Club and its respective
directors, officers, committee members, members, employees, volunteers,
participants, agents and representatives are not responsible for any injury,
personal injury, damage, property damage, expense, loss of income or loss of any
kind suffered by the Participant during, or as a result of, any of the Activities
sanctioned by one or more of CCC/CSA, the Division and the Club, caused by the
risks, dangers and hazards associated with the Activities.

The Parties confirm that:
the Participant's physical condition is sufficient to allow participation
in the sport of cross-country skiing and the activities, events and programs
of CCC/CSA, the Division and the Club;

they have been provided sufficient information about the Activities and the
associated risks and hazards so that they are aware of the effect of this

the Participant agrees to abide by the Rules and Regulations imposed by
CCC/CSA, the Division and the Club, in association with the Activities, and
to follow the instructions of the officials during the Activities; and

they have read this agreement, understand it, have executed this agreement
voluntarily, and that this agreement is to be binding upon the Parties,
their heirs, executors, administrators and representatives.

In addition, the Parties:
authorize CCC/CSA, the Division and the Club to collect and use personal
information about the Parties which relates in any way to the Activities,
including without limitation the publication of photographs in newsletters
and promotional materials, and the posting of photographs, videos, articles,
rosters, statistics, images and results on the CCC/CSA, the Division and the
Club websites;

grant permission to CCC/CSA, the Division and the Club to photograph and/or
record the Parties' image and/or voice, and to use this material to promote
CCC/CSA, the Division and the Club through any form of and agree that the
audio/visual material and copyright will remain the sole property of
CCC/CSA, the Division and the Club and waive any claim to remuneration for
use of audio/visual materials used for these purposes; and

understand that they may withdraw such consent at any time by contacting
Cross Country Canada at 403-678-6791. Cross Country Canada will advise the
implications of such withdrawal.

*We do not sell or distribute your personal information to any other third party not
listed herein.*

I have read and I accept the above Informed Consent and Assumption of Risk
Agreement for myself and any immediate family members (spouse and children) as
indicated on the following registration form pages: Check Box

Signature of Witness
Signature of Member

Print Name of Witness
Print Name of Member

Date Witness Signed
Date Member Signed