New Member Registration Form

First Name*
Last Name*
Nick Name
Phone 1
Type CellHomeWork
Phone 2
Type CellHomeWork
Phone 3
Type CellHomeWork
In Case of Emergency (ICE) Name
ICE Phone
Type CellHomeWork
Birth Month
Birth Day
I would like to participate in the following activities
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.