BRISBANE
CATHOLIC BUSHWALKING CLUB INC.
(Incorporated under the Associations
Incorporation Act, 1981)
APPLICATION FOR MEMBERSHIP
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SURNAME |
CHRISTIAN NAMES |
Date of Birth |
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Residential Address |
Skills I Have That Could Aid The Club |
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Postal Address: |
CAR: Type, Number of Passengers & Rego |
Occupation (Optional) |
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e-mail
Address |
Home Phone |
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Work (Optional) |
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Next of
Kin & Relationship |
Address |
Contact Number |
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Medical Conditions (including allergies &
disabilities) |
Membership Category |
Fee $ |
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Tick here if your Address & Phone
Nos are not to be published in the Membership List. (NOTE: All Names
are published, only addresses & phone Nos are suppressed. If you are
leading a Club event, your name & phone number
will be at the head of the Jilalan article. From time to time, names are
included in stories in Jilalan. Activities, with all
details, are put on the Club’s Web Site.)
I wish to have the Club’s monthly
newsletter “Jilalan” e-mailed to me.
I acknowledge that photos of me can
appear in Jilalan and on the Club’s web site.
Membership fees are due on the 1st
of January each year. There is a reduction for New Members as the year
progresses.
Unfinancial members wishing
to renew during the year pay the full year’s amount.
The minimum age for a Member is 18
years.
To be admitted as a Member, the Applicant
must have already done 2 outings with the Club in the current Club Year and
pay the Subscription amount before or
with this Application. See the reverse for the full range of
membership classes.
Current financial members must Nominate and Second all Applicants.
“Ordinary” Membership category is
open only to persons of the Catholic Faith.
“Associate” Membership is only open
to persons not of the Catholic Faith.
An Applicant has to be declared a
member by the Management Committee after receipt of this correctly completed form,
the fee and verification that the
outings have been done.
Please Read The Important Notice Below
RELEASE, WAIVER & INDEMNIFICATION
All persons, adult or child, member
or visitor, undertake all activities of the Club at their own risk. The Club is
not even in the
position to state that all care will be
taken.
I, the undersigned, hereby take
action for myself, my executors, administrators, heirs, next of kin, successors
and assigns as follows:
I waiver, release, discharge,
indemnify and hold harmless the following from any and all liability,
responsibility and claims, for my
death, disability, personal injury,
property damage, property theft or actions of any kind which may hereafter
result from my
participation in any
activity of the Brisbane Catholic Bushwalking Club Inc.
The Brisbane Catholic Bushwalking Club Inc. All members of
the Brisbane Catholic Bushwalking Club Inc.
The Management Committee of the Brisbane Catholic Bushwalking Club
Inc.
The leader of any activity of the Brisbane Catholic Bushwalking
Club Inc.
Any visitor on any activity
of the Brisbane Catholic Bushwalking Club Inc.
The owner, resident or occupier of any place where the Brisbane
Catholic Bushwalking Club Inc. holds an activity.
Thedriver and/or owner of any vehicle used in relation of
any activity of the Brisbane Catholic Bushwalking Club Inc.
The land holder and/or
occupier of any land that the Brisbane Catholic Bushwalking Club Inc uses,
crosses over, camps on during
any activity of the Club.
I acknowledge that activities of the
Brisbane Catholic Bushwalking Club Inc carry with them the potential for death,
serious injury
and property loss.
I hereby assume any and all risks
associated with participating in any activity of the Brisbane Catholic
Bushwalking Club Inc.
This form shall be construed
basically to provide a release, waiver and indemnification to the maximum
extent possible under the
applicable laws.
I hereby apply for membership in the
designated category. In the event of my admission as a member, I agree to be
bound by the Rules and By Laws of the Club
for the time being in force.
I acknowledge that I have read this form and fully understand its
contents, including the
Release, Waiver & Indemnity.
Signature: ______________________________ Date:
__________________
We, the following financial members
of the Club, nominate and second this Applicant who is
personally known to us,
and for whom we personally accept
responsibility, for membership of the Club.
Nominator Sig: ____________I Have Known Applicant for: __ Seconder Sig: _____________I Have Known Applicant for: _
Name Printed: ______________________________ Name Printed: ______________________
Outings Completed: 1.____________________
on__/____/____ 2. ___________________________ on_____/___/__