Blind Outdoor Adventure Team Membership Form

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Blind Outdoor Adventure Team activities include tandem biking, hiking, kayaking and more... Membership is free of charge and open to anyone over 18 wishing to be involved with and follow the rules of the team.

Member Category *

Stoker

Captain

Substitute captain

Captain in training

Single cyclist

Hiking participant

Hiking guide

Kayaking guide

Kayaking participant

Other support

Required

Do you own a tandem? *

Cell phone? *

Email address *

Your Height (feet and inches) *

Your Weight (pounds) *

Date of Birth *

YYYY

Emergency Contact. Include name, last name, phone number of your emergency contact. *

Your brief reason for wanting to join Blind Outdoor Adventure Team *

Describe experience in outdoor activities (cycling, hiking, kayaking etc) *

If blind participant explain sight loss (partial/total since when) and other medical conditions and allergies if there is any. *

Indicate your fitness goals for the year. *

Liability Waiver and contact information release: I acknowledge I understand the intent of this liability waiver and know I have the right to consult an attorney before signing it. I agree for myself, my heirs, my executors, administrators and representatives to waive any and all rights and claims for damages against any and all persons associated with the Blind Outdoor Adventure Team, and will absolve and hold them harmless for any and all injuries, death, harm, loss or damages related to the Blind Outdoor Adventure Team or related activities. I acknowledge outdoor sports are dangerous and represent I am physically capable to participate in cycling, kayaking and hiking activities. I agree to observe all applicable traffic rules, wear a proper protective gear and conduct myself in a safe and prudent manner while participating in all activities. I understand my personal contact information will be shared with all club members for the purpose of this organization's mission. I consent to and permit emergency medical treatment in the event of injury or illness while participating in activities related to the Blind Outdoor Adventure Team. *check both boxes after reading Waiver and Program Description *

I understand and accept the Liability Waiver.

I certify that I have read the BOAT Program Description and I understand my responsibilities.

Required

First name *

Last name *

Which city do you live in? *

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