Escape XXVII Registration Form - July 5th to 8th 2001
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Captain's Name:
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Address
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City
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State/Prov:
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Zip/Postal Code
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Home Telephone:
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Business Telephone:
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Home Fax
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Business Fax:
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Email Address:
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Crew's Names:
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Boat Name:
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Length of Boat:
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Normal or Preferred Cruising Speed:
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How many from your boat will be attending the following?
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Thursday Supper at Totem Lodge:
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Friday Supper at Wiley Point Lodge:
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Saturday Supper at Sunset Lodge:
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RELEASE AND INDEMNIFICATION
WHEREAS, ESCAPE CRUISE INC. IS A NON-PROFIT CORPORATION REGISTERED UNDER THE LAWS OF THE STATE OF MINNESOTA.
AND WHEREAS ESCAPE CRUISE INC. PERFORMS ORGANIZATIONAL FUNCTIONS RELATED TO BUT NOT LIMITED TO THE FOLLOWING EVENTS:
- NO BOAT BANQUET AND DANCE
- SPRING CRUISE
- DIVISION LEADERS' MEETING
- ESCAPE CRUISE
- FALL CRUISE
AND WHEREAS SUCH ORGANIZATIONAL FUNCTIONS INCLUDE BUT ARE NOT LIMITED TO ARRANGEMENTS FOR LODGING, MEALS AND ENTERTAINMENT AND ASSIGNMENT OF BOATS TO DIVISIONS.
AND WHEREAS I HAVE BEEN ADVISED BY ESCAPE CRUISE INC. THAT ESCAPE CRUISE INC., IT'S DIRECTORS, ADMINISTRATORS AND THEIR HEIRS, SUCCESSORS AND ASSIGNS, ARE NOT RESPONSIBLE FOR ANY LOSS OR DAMAGE TO MY BOAT AND/OR PERSONAL PROPERTY AND/OR EQUIPMENT; ARE NOT RESPONSIBLE FOR ANY LOSS OR DAMAGE TO PERSONAL PROPERTY AND/OR EQUIPMENT OF ANY AND ALL PASSENGERS TRAVELLING ON MY BOAT; ARE NOT RESPONSIBLE FOR PERSONAL INJURY SUSTAINED BY MYSELF AND/OR ANY AND ALL PASSENGERS TRAVELLING ON MY BOAT; AND ARE NOT RESPONSIBLE FOR ANY LOSS AND/OR DAMAGE TO PERSONAL PROPERTY AND/OR EQUIPMENT AND/OR PERSONAL INJURY TO ANY PERSON RESULTING FROM THE OPERATION OF MY BOAT.
AND WHEREAS I ACKNOWLEDGE THAT I AM RESPONSIBLE FOR THE SAFETY OF ANY AND ALL PASSENGERS TRAVELING ON MY BOAT, AND THEIR PERSONAL PROPERTY AND/OR EQUIPMENT, AND FOR ANY PERSONAL INJURY, LOSS OR DAMAGE SUSTAINED BY ANY PERSON RESULTING FROM THE OPERATION OF MY BOAT, AND THAT I HAVE BEEN ADVISED TO CARRY LIABILITY INSURANCE IN THIS REGARD COVERING THE OPERATION OF MY BOAT DURING ESCAPE ACTIVITIES.
NOW, THEREFORE, I DO HEREBY COVENANT AND AGREE THAT I WILL HEREAFTER INDEMNIFY AND SAVE HARMLESS THE SAID ESCAPE CRUISE INC., IT'S DIRECTORS, ADMINISTRATOR, AND THEIR HEIRS, SUCCESSORS AND ASSIGNS, FROM ALL CLAIMS AND DEMANDS, SUITS AND/OR ACTIONS RESULTING FROM MY PARTICIPATION IN ESCAPE ACTIVITIES AND/OR RESULTING FROM THE OPERATION OF MY BOAT DURING ESCAPE ACTIVITIES.
DATED THIS ____________ DAY OF __________, 2001
FULL NAME: (type or print)_________________________
SIGNATURE:_________________________
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Completed registration forms and duly signed and dated release and indemnification forms are to be returned to Escape Cruise Inc. Please return them as quickly as you can as they are required for planning and division management. The sooner we have an idea as to how many people to expect, the easier our jobs are.
Please mail with payment $35 US or $50 CA to Al Halfaker, 20134 Bluebird Dr., Grand Rapids, MN 55744
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