North Okanagan Naturalists' Club Member Family Form 
Sign in to Google to save your progress. Learn more
Full Name *
Email *
Phone Number
Mailing Address & Postal Code *
Additional Family Members for Family Membership *
Additional Family Members Email
Additional Family Members Phone Number
BC Nature Magazine *
Captionless Image
Please indicate payment method *

I, the participant, authorize the North Okanagan Naturalists’ Club and the Federation of British Columbia Naturalists to collect and use personal information about me for the purpose of receiving communications, including newsletters, e-mails and posting articles and images on the North Okanagan Naturalists’ Club’s website or BC Nature website. (Neither the North Okanagan Naturalists’ Club nor the Federation of British Columbia Naturalists will sell or distribute your personal information to any other third party not listed herein.) 

I understand that I may withdraw such consent at any time by contacting the North Okanagan Naturalists’ Club’s secretary.  The secretary will advise the implications of such withdrawal. 

*
NORTH OKANAGAN NATURALISTS’ CLUB INFORMED CONSENT AND ASSUMPTION OF RISK AGREEMENT 

  DISCLAIMER
 This is a binding legal agreement.  As a Participant in the programs, activities and events of the North Okanagan Naturalists’ Club and the Federation of BC Naturalists, the undersigned acknowledges and agrees to the following terms: 

The North Okanagan Naturalists’ Club and the Federation of BC Naturalists and their respective directors, officers, committee members, members, employees, volunteers, participants, agents and representatives (collectively the “Organization”) are not responsible for any injury, personal injury, damage, property damage, expense, loss of income or loss of any kind suffered by a Participant during, or as a result of, any program, activity or event of the Organization, caused by the risks, dangers and hazards associated with the programs, activities and events of the Organization.

  DESCRIPTION OF RISKS 

I am participating voluntarily in these actives, events and programs of the Organization.  In consideration of my participation in the programs, activities and events of the Organization, I hereby acknowledge that I am aware of the risks, dangers and hazards associated with or related to any such programs, activities and events of the Organization and may be exposed to such risks, dangers and hazards. The risks, dangers and hazards include, but are not limited to, injuries from:

 a)    Field trips and outings; 

b)     Nature walks;

c)     Bird counts and watching;

d)     Road cleanup;

e)     Animal attacks, including but not limited to, bears, cougars and snakes;

f)      Extreme weather conditions which may result in heatstroke, sunstroke, hypothermia, frostbite, or lightening strikes;

g)     Inhalation of  viruses or infections including but not limited to, Hantavirus Pulmonary Syndrome;

h)     Executing strenuous and demanding physical techniques including climbing and hiking; i) Vigorous physical exertion;

j)      Grass, turf and other surfaces including bacterial infections and rashes;

k)     Falling to the ground due to uneven, slippery, steep, rocky or irregular terrain or surfaces;

l)      Failure to properly use any piece of equipment or from the mechanical failure of any piece of equipment;

m)    Spinal cord injuries which may render me permanently paralyzed; and

n)     Travel to and from activities, events and programs.  

 1.    Furthermore, I am aware:

 a)     That injuries sustained can be severe;

b)     That I may experience anxiety while challenging myself during the activities, events and programs;

c)     That my risk of injury is reduced if I follow all rules established for participation; and 

d)     That my risk of injury increases as I become fatigued

RELEASE OF LIABILITY

 2.     In consideration of the Organization allowing me to participate, I agree: 

 a)    That I do not know of any medical condition I might have that could possibly make it unwise from me to participate in the club’s activities, events or programs, including but not limited to heart conditions;

b)    To freely accept and fully assume all such risks, dangers and hazards and possibility of personal injury, death, property damage, expense and related loss, including loss of income, resulting from my participation in such activities, events and programs; 

c)     To forever release the Organization from any and all liability for any and all claims, demands, actions and costs that might arise out of my participation in the activities, events and programs of the Organization.

 ACKNOWLEDGMENT

ACCEPTANCE OF TERMS AND CONDITIONS

In consideration of the acceptance of my membership in the North Okanagan Naturalists’ Club, I, the participant agree as follows: 

 To abide by the policies, rules and regulations of the North Okanagan Naturalists’ Club. 

I have reviewed the Assumption of Risk agreement and my signature affixed hereto indicates my agreement with such Assumption of Risk agreement. 

I accept sole responsibility for my personal possessions and equipment (if applicable).   

 I acknowledge that I have read this form in its entirety and that I have executed this membership agreement voluntarily. 

  I acknowledge that I have read this agreement and understand it, that I have executed this agreement voluntarily, and that this agreement is to be binding upon myself, my heirs, executors, administrators and representatives.

PLEASE TYPE NAME IN THE LINE BELOW TO ACCEPT

*
PLEASE TYPE SECOND FAMILY MEMBERS NAME IN THE LINE BELOW TO ACCEPT *
PLEASE ADD SIGNING DATE BELOW *
MM
/
DD
/
YYYY
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.