Randonnée Aventure - Randonnee Aventure

Randonnée Aventure
Registration Form Summer/Fall 2014
www.randonnee.ca
Please print clearly
First name: _______________________ Last name: ______________________________
Address: __________________________________________________ Apt: __________
Please mark if:
New member
Some information has
changed
City: ___________________________Prov: __________ Postal Code: _______________
Phone: home _____-_____-________ work _____-_____-__________ ext.: _________
E-mail: __________________________________________________
25
I agree to receive all correspondence by e-mail
Next of kin: name____________________________________________________________Tel:___________________________
Important – Randonnée Aventure needs your help!
Our success depends on the efforts of our membership. Please mark the area(s) that you would like to help out with:
Ski Committee
21 Assist in leading a hiking trip
Cycling
Committee
3
18 Assist in leading a cycle trip
Hiking
Committee
4
20 Scouting a hiking destination
Social
Committee
8
19 Scouting a cycle destination
24 I don’t have a specific preference but want to help out
1
Newsletter production
9 Help at social events
Newsletter
mailing
6
11 Help plan weekend events
Help
with
the
Club
Web
site
7
23 Pick up Club mail
Telephone
calling,
relaying
Club
messages
10
5
Newcomers -- how did you first hear about Randonnée Aventure?
12
A friend
13
Store/flyer
14
The Montreal Gazette
15
Other newspaper
16
Internet
Membership Fees Annual Membership: $20
Please verify membership expiry date on mailing label.
17
Radio
$___________
Note: Payment must be on a separate cheque, not postdated.
• Before registering, check which trips are sold out at the Club
web site: www.randonnee.ca.
Cycling Day Trips
No registration is required for Saturday carpool or meet-and-ride
trips. See the Randonnotes or Club web site for full trip list, prices
and meeting locations.
• After registering you cannot switch trips. However, the Club
offers a buy/sell procedure.
• Newcomers may buy one Day Trip before becoming a member.
• Confirmation of your trip registrations will be sent to you.
Hiking Day Trips
Please mark your choices clearly with an X.
1
2
3
4
5
6
7
8
9
10
11
12
13
May 24
June 07
June 14
July 12
July 26
Aug. 09
Aug. 23
Sept. 06
Sept. 13
Sept. 20
Sept. 27
Oct. 04
Oct. 18
Sat.
Sat.
Sat.
Sat.
Sat.
Sat.
Sat.
Sat.
Sat.
Sat.
Sat.
Sat.
Sat.
Mont St-Hilaire, QC (Carpool trip, $7/driver, $6/park entrance fee)
4 I have a car for carpooling
Les Contreforts, N-D de la Merci, QC
Mt Hurricane, Elizabethtown, NY, USA*
Keene Valley, NY, USA*
Grand Vallée, Chertsey, QC
*Important: For trips to the US, bring your required
Matawinie, Ste Emilie de l’Energie, QC
documents. If you are not a Canadian or US citizen,
you may need to be fingerprinted and photographed
Mystery Hike, QC
when crossing the border.
Mont Ouareau & Mont Kaaïkop, L’Interval, QC
ADK Loj, Lake Placid, NY, USA * (Extended)
Parc Mont Mégantic, N-D des Bois, QC
Mansfield West, Underhill Center, VT, USA* (Extended)
Noonmark & Round, Keene Valley, NY, USA*
Parc Mont Tremblant, Mont Tremblant, QC
Trips 2 - 12: ______ x $38 per trip
= $ _________
Pre-paid Price: $38 per trip
- Payment by mail must be received by the Club two weeks before the trip.
- On-line payment must be made before 9 pm on the Wednesday prior to the trip.
On-Bus Price: $45 per trip
- Trips paid for on the bus do not benefit from the above discounted pricing.
Subtotal (not including membership fee - carry to other side)
Trail Maintenance - I’m interested in participating.
Vermont:
72 Aug. 15-17
73 Oct. 17-19
New York:
74 Sept. 19-21
$ __________
Randonnée Aventure
Registration Form Summer/Fall 2014
page 2
Subtotal carried from other side (not including membership fee)
$ _____________
Weekend Getaways (carpool)
See the Club web site or Randonnotes for full details about weekends. Registration is limited and first come, first
served. Weekends are non-refundable, however the Club has a buy/sell procedure; see the web site or Randonnotes.
Non-members must complete the membership section on the other side and include a separate $20 membership cheque.
Saint-Jean-Baptiste Hiking/Cycling Weekend, Friday, June 20 - Tuesday, June 24
Lincoln, New Hampshire, USA
51
I plan to:
8
2
4
$225 (Payment must be received by May 9).
$ __________
I would like to share a room with ______________________________________ (optional)
Cycle
3 Hike
I have a car for carpooling 5 I have a bike rack 6 I will coordinate my condo Carpool fee $60 payable to driver
Labour Day Hiking/Cycling Weekend, Friday, August 29 - Monday, September 1
Stowe, Vermont, USA
52
I plan to:
8
2
4
$240 (Payment must be received by August 1).
I would like to share a room with ______________________________________ (optional)
Cycle
3 Hike
I have a car to carpool
Carpool fee $40 payable to driver
5 I have a bike rack
$ __________
Thanksgiving Day Hiking Weekend, Friday, October 10 - Monday, October 13
Waterville Valley, New Hampshire, USA
52
8
4
$190 (Payment must be received by September 19).
I would like to share a room with ______________________________________ (optional)
I have a car to carpool
Carpool fee $65 payable to driver
$ __________
Weekender Cycle Trips (carpool)
Friday, July 4 - Sunday, July 6 (2 nights)
Nomingue, Quebec
55 8
4
$185 (Payment must be received by May 30)
I would like to share a room with ______________________________________ (optional)
I have a car for carpooling
Carpool fee $45 payable to driver
5 I have a bike rack
$ ___________
Friday, August 1 - Sunday, August 3 (2 nights)
Levis, Quebec
56 8
4
$195 (Payment must be received by June 30)
I would like to share a room with ______________________________________ (optional)
I have a car for carpooling
Carpool fee $50 payable to driver
5 I have a bike rack
$ ___________
Total for all activities, payable to Randonnée Aventure
$ ___________
$20 Membership Fee if due, use a separate cheque payable to Randonnée Aventure
$ ___________
Please complete and sign the waiver below. We require that you sign a new
waiver each season.
Veuillez compléter et signer la demande ci-dessous. Nous avons besoin
d’une nouvelle demande à chaque saison.
APPLICATION FOR MEMBERSHIP AND WAIVER
DEMANDE D’ADHÉSION ET DE DÉGAGEMENT
TO: RANDONNÉE AVENTURE (the "Club")
A: RANDONNÉE AVENTURE (le Club)
I understand that the Club is a not for profit corporation managed by non-professional volunteers, that the objects of the
Club are, among other things, to facilitate participation by members in wilderness and other recreational activities and that
participation in such activities involves significant risk of bodily injury or death. I understand that none of the Club, its
members, directors, officers, servants, agents or other representatives (collectively, the “Club Organizers") has any
expertise in connection with such activities and that I am solely responsible for determining my ability to participate in such
activities.
In consideration of being permitted to participate in activities organized by the Club, I agree that my participation, and that
of any minors accompanying me in such activities, shall be entirely at my own risk, and upon my own responsibility.
Furthermore, I agree that if my privilege of participation in a Club activity is transferred to another person, in any form
whatsoever, or if I purchase an activity for another person, I will ensure that the person actually participating will provide
the Club with a duly completed waiver of responsibility prior to the start of the activity and that, if such a waiver is not
provided to the Club, I will indemnify and hold the Club and the Club Organizers harmless from and against all liability, loss,
cost or damage arising out of, or in connection with, the participation of that person in the activity in question.
I hereby assume, to the complete exoneration of the Club and the Club Organizers all risks of such participation, including
travel. I hereby renounce all claims and rights of action, present and future, of whatsoever nature against the Club and the
Club Organizers in respect of loss, cost or damage (including, without limitation, bodily injury or death and damage to or
loss of property) arising out of or in connection with my participation in such activities, whether or not such loss, cost or
damage is caused by the fault of the Club or the Club Organizers and I hereby forever release and discharge the Club and
the Club Organizers therefrom and agree to indemnify and hold the Club and the Club Organizers harmless from and
against all liability, loss, cost or damage arising out of or in connection with such participation.
I confirm that I have requested an English language version of this document, a French language
version being available.
Je reconnais que le Club est une corporation à but non lucratif gérée par des volontaires non-professionnels, que les
buts du Club sont, entre autres, d’aider les membres à participer à des activités en pleine nature ainsi qu’à d’autres
activités récréatives et que cette participation peut comprendre des risques importants, de blessures corporelles ou de
mort. Je reconnais que ni le Club ni ses membres, administrateurs, dirigeants, préposés, agents ou autres
représentants (appelés collectivement les Organisateurs) ne possèdent d’expertise relative aux dites activités et que je
suis seul(e) responsable de déterminer ma capacité d’y participer.
En considération de mon acceptation comme membre du Club, ou que la permission me soit accordée de participer aux
activités organisées par le Club, je conviens par la présente que ma participation, et celle de toute personne mineure
qui m’accompagnerait aux dites activités, sera ma responsabilité,.
En outre, je conviens que si je cède ma participation à une activité du Club à une autre personne, de quelque forme que
ce soit, ou si j’achète une participation à une activité pour une autre personne, il est de ma responsabilité de m’assurer
que cette personne fournisse au Club un dégagement de responsabilité dûment rempli, avant le début de l’activité et
que, si ledit dégagement n’est pas fourni, je garantis le Club contre toute responsabilité, perte ou dommages découlant
de, ou en rapport avec, la participation de cette personne à l’activité en question.
J’accepte par la présente, à la libération complète du Club et des Organisateurs, tout risque d’une telle participation, y
compris tout risque relié au transport, je renonce par la présente à toute réclamation et droit d’action, présent et futur, de
quelque nature que ce soit contre le Club et les Organisateurs concernant la perte ou les dommages (y compris, sans
limitation, les blessures corporelles ou la mort et les dommages à mes biens ou la perte de ces derniers) provenant de,
ou relative à ma participation aux dites activités, même s’ils sont dus à la négligence du Club ou des Organisateurs et je
donne par la présente quittance complète et finale au Club et aux Organisateurs et conviens de les tenir indemnes de
toute responsabilité, perte ou dommage provenant de, ou relative à une telle participation.
Daté ce ______ ième jour de _________________ 2014
Dated this ______ day of _____________________ 2014
Signature:
Signature:
Name:
Prénom, nom:
(Please Print)
(lettres moulées)
Mail this form and all cheques to:
RANDONNEE AVENTURE
PO BOX 26541 RPO QUEEN MARY
MONTREAL QC H3X 4B1