In consideration of my being permitted to participate in the events, activities, and/or functions (all of which are hereafter called "the events") offered or organized by VICTORIA CLUB TREAD, I hereby, for myself, my heirs, executors, administrators, and assigns, release and forever discharge VICTORIA CLUB TREAD, its officers, managers, servants, agents, and volunteer leaders (all of whom are hereafter called "The CLUB"), from any and all lawsuits or actions, claims, or demands by reason of any damage, loss, death, or injury to myself or to my property arising from my participation in the events, notwithstanding that the same may have been contributed to or occasioned by the negligence of the CLUB.

I agree to save and make harmless and indemnify the CLUB from and against all lawsuits, claims, actions, costs, or expenses in respect to any death, injury, loss, or damage to myself or my property howsoever caused, arising out of or in connection with the events and whether the same may have been contributed to or occasioned by the negligence of the CLUB.

I recognize and acknowledge that there are inherent risks and hazards involved in participating in the events including, but not restricted to, such hazards as danger from avalanches, sudden changes in weather, falls on steep terrain, failure of equipment, and the possibility of becoming lost, as well as all other hazards associated with hiking, mountaineering, wilderness travel, and any other pursuits of the CLUB, and I further agree to bear any and all costs of rescue or medical attention rendered to me personally and arising from my participation in the events.

(please print)

New: _______ Renewal: _______


ADDRESS:____________________________________________________________________
__________________________________ POSTAL CODE: __________________________
Home Phone: _______________________
NAME: ______________________________ * Alternate Phone (e.g.work):________________
* Email address:_________________________________________
NAME: ______________________________ * Alternate Phone (e.g.work):________________
* Email address:_________________________________________
[if application covers more than two people, please use the reverse for the additional applicants]
* Optional - if provided will be included in Membership Phone List
NEW APPLICANTS: List three outdoor events you attended in the past year
Event:_________________________________________________ Date:__________________
Event:_________________________________________________ Date:__________________
Event:_________________________________________________ Date:__________________

Trip coordinators have the authority to set guidelines for smoking, consumption of alcohol, participation of children and pets, and minimum fitness levels of participants. Each member must act in a safe and responsible manner at all times. Members should be properly equipped for the activity and are encouraged to carry a personal first aid kit.

Annual dues: Single $25, Couple $40. New members after September 1st: Single $15, Couple $25.

I HAVE READ THE INDEMNITY AND RELEASE OF LIABILITY AND ACCEPT ITS TERMS AND CONDITIONS.

NOTE: If application covers a couple, both must sign.	Signature:____________________________
If application covers a family, all and only adults must sign.	Signature:____________________________

Mail application with payment to: Victoria Club Tread
c/o Jacquie Hunt
#301 - 2230 Cadboro Bay Road
Victoria, BC  V8R 5G9