Email Address

Are You An Existing Member? (Renewing)
No Yes

First Name *

Last Name *

Address *

City *

State *

Zip *

CounTY *

Phone *

Occupation

Where did you hear about O&A?

Are you single (Legally divorced, never married, widowed)? *
Yes No

Gender *
Male Female

Birth month and day (ex. Jan 1) *

For planning purposes, please tell us your age range? *
21-39 40+

Do you wish to have your phone number published in our roster? (Only distributed to O&A members)
Yes No

E-mail addresses are NOT distributed and are only used by club administrators. OK to use?
Yes No

Would you be willing to assist in running an Activity in the future?
Yes No Possibly

If so, which one(s)?

Please check the activities that interest you

I hereby appoint Outdoors and Active, Inc. (herein O&A), its officers and agents as my agent to perform all acts and to enter into any and all contracts as may be deemed desirable in connection with any O&A activity. I understand that O&A acts only as a coordinator and accepts no responsibility for the services of any person, ski area, raft trip, airline, motor coach, hotel, or any organization whatsoever rendering any of the services or accommodations being offered on any trip or outing. Activity fees are based upon current tariffs and are subject to change without notice. O&A accepts no responsibility in whole or in part for any delays, delayed departure or arrival, missed plane or other carrier connections, loss, damage or injury to personal property, mechanical defect or failure of any nature, howsoever caused, or any substitution of hotels or of common carrier, with or without notice, or for any additional expenses occasioned thereby. I fully understand that O&A is a voluntary association run by volunteers who have no special training in conducting activities. By participating, I do not rely upon the expertise of any director, officer, activity coordinator or the agents of any of the foregoing. I agree that I am solely responsible for my personal safety and conduct. Furthermore, I, on behalf of myself, my heirs, executors, successors and assigns, hereby voluntarily release, discharge, waive and relinquish any and all actions or causes of actions for personal injury, property damage or wrongful death rising out of or resulting from my participation in any O&A sponsored activity which have or may have now or in the future against O&A, its officers, directors, activity coordinators, members and agents for any said causes of action whether the same shall arise by the negligence of any of the said persons or otherwise.

I understand and agree that it is the intention and purpose of this document to exempt and relieve O&A as well as its officers, directors, activity coordinators, members and agents from any and all liability from personal injury, property damage or wrongful death caused by negligence on any of the aforesaid persons. I agree to indemnify and hold harmless O&A, its directors, officers, activity coordinators, members or agents or contractors from any loss, cost or expense incurred by or attributable in any way to me in connection with any activity. I agree to abide by the bylaws (bylaws available upon request) rules and regulations of O&A, and the trip and/or activity coordinators in conjunction with any activity and to meet all payment deadlines. The Board, in its absolute discretion, reserves the right to deny application to and to subsequently remove from membership any person deemed to be an unsuitable candidate for membership or unsuitable member so long as denial or removal is not based on race, religion, creed, sex, national origin, or any other discriminatory practice that would be in violation of any state or federal statute. By signing below, I hereby agree to all terms and conditions listed above.

By signing below, I hereby agree to all terms and conditions listed above.

Signature (type your full name) *