New Member Registration Form First Name* Last Name* Nick Name Email* Street* City* State* Zip* Phone 1 Type CellHomeWork Phone 2 Type CellHomeWork Phone 3 Type CellHomeWork In Case of Emergency (ICE) Name ICE Phone Type CellHomeWork SexMaleFemale MaritalSingleMarried Birth Month ---123456789101112 Birth Day ---12345678910111213141516171819202122232425262728293031 I would like to participate in the following activitiesSki- Racing- Membership- Tennis- Vollyball- Social- Ways & Means- Public Affairs- Computer- Golf- Directory Your message Release of Liability In consideration of the BSSC's acceptance of my membership and renewal thereof, and for other good and valuable consideration, I, on my behalf and the behalf of my legal representatives, including my spouse, if any, and insurers, do hereby waive, release and forever discharge the BSSC, its officers, directors, employees and agents including but not limited to activity leaders, of and from any and all claims, loss, cost, damage to property which I may sustain as a consequence of the negligence of any such entity or person in connection with or related to any activity arranged, organized, sponsored or managed by BSSC, including transportation to and from such activity. I understand that the BSSC will not accept my membership unless I sign or check 'Accept' of this Release, which I have read and to which I voluntarily agree. Accept