Randonnee Aventure - Randonnée Aventure

Randonnée Aventure
Winter 2015 Registration Form
www.randonnee.ca
514-359-6781 (NEW)
As an alternative to mailing this form, RA offers online registration and payment on our web site.
Please print clearly
Please mark if:

First name: _______________________ Last name: ______________________________

New member
Address: __________________________________________________ Apt: __________

Some information has
changed
City: ___________________________Prov: __________ Postal Code: _______________
Phone: home _____- _____-__________ work _____- _____-__________ ext.: ______ Cell: ____-____-________
Email: __________________________________________________
I
25
agree to receive confirmation and information from Randonnée Aventure 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:
1
Ski/Snowshoe Committee 2 19 Translation
20 Marketing/Advertising
Cycling Committee 9 Help at social events
4 Hiking Committee
11 Help plan weekend events
10 Telephone calling, relaying Club messages

Social
Committee

Help
with
the
Club
web
site
8
7
21 Follow-up with new / potential members
26 Help with registrar’s program (knowledge of Microsoft Access programming required)
3
24
I don’t have a specific preference but want to help out
Membership Fees Annual Membership: $20
Please verify membership expiry date on mailing label.
[ 60
Sat Dec 6
$_________
Note: Payment must be on a separate cheque, not post-dated.
RA Annual Holiday Party, Portuguese Cultural Centre
Deadline for ticket purchase Nov. 22 (tickets will not be available at the door).
_________x $40
$_________
REMEMBER:
Cross-Country Ski & Snowshoe Day Trips

All trips have options to cross-country ski or snowshoe

Please indicate your choices clearly with an X
1
2
3
4
5
6
7
8
Jan. 3
Jan. 10
Jan. 17
Jan. 31
Feb. 7
Feb. 14
Feb. 21
Feb. 28
Sat.
Sat.
Sat.
Sat.
Sat.
Sat.
Sat.
Sat.
Total for trips 1 - 8:
Before registering, call the Club at 514-359-6781
or visit our web site at www.randonnee.ca for
up-to-date information on which trips are sold out.
 Newcomers can take one skiing, snowshoeing,
cycling or hiking trip before requiring a membership.
 After registering, you cannot switch trips; however,
we have a Buy/Sell procedure. See Randonnotes
or the Club website for details.
 You can’t register for sold-out day trips. Try the
Buy/Sell procedure or wait at the last pickup point.
 Register before Dec. 19 and save $5-$13 on day
trips. Cheques can be postdated to Dec. 19.
 Confirmations will be sent by mail or email.
 Destinations may change due to snow conditions.
Domaine St-Bernard, Mont-Tremblant
Lac Monroe, Parc du Mont-Tremblant
Far Hills, Parc regional de Val-David/Val Morin
Parc Forêt Ouareau, St-Donat
Parc national du Mont-Orford, Orford
Parc national de la Mauricie, St-Jean-des-Piles
Camping Ste-Agathe/Centre de plein air St-Adolphe d’Howard
Parc Dufresne, Parc régioinal de Val-David/Val Morin (end-of-season pub stop)
_____ x $37 each until Dec. 19,
_____ x $42 for payments dated or received after Friday, Dec. 19 =
$_________
Early bird Price:$37 per trip
Payment must be received by Friday, Dec 19
Pre-paid Price: $42 per trip
Payment by mail must be received two weeks before the trip.
On-line payment must be made before 9 pm on the Wednesday prior to the trip.
On-Bus Price:
Trips paid for on the bus do not benefit from the above discounted pricing.
$50 per trip
Sub-total
$_________
Randonnée Aventure
Page 2
Winter 2015 Registration Form
Sub-total from other side (not including membership fee)
$_________
Canadian Ski Marathon, February 7 - 8, 2015
40
 I am interested in participating in the Canadian Ski Marathon
Weekend Getaways




See Randonnotes or the Club website for complete details about weekends.
Space is limited and registration is first come, first served.
Weekend trips are non-refundable. However, there is a Buy/Sell procedure. See Randonnotes or the Club
website for details.
Non-members please complete the membership section on the other side and include a separate $20
cheque for membership.
Winter Weekend, Friday, January 23 – Sunday, January 25, 2015
Saint-Raymond-de-Portneuf, Québec
53
 $275 if received by Friday, Dec. 19, otherwise $295. No postdated cheques please.
8
 I would like to share a room with _______________________________________________(optional)
$_________
Cheques to be made payable to Randonnée Aventure
8
 I would like to share a room with _______________________________________ (optional)
One cheque for total of all ski/snowshoe activities and party
$__________
One $20 cheque for membership if due, not postdated:
$__________
Please complete and sign the waiver below.
Veuillez compléter et signer le dégagement ci-dessous.
WAIVER
DÉGAGEMENT
TO: Randonnée Aventure (the "Club")
À: Randonnée Aventure (le Club)
I understand that the Club is a not for profit corporation managed by nonprofessional 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.
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.
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.
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,.
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.
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.
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.
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.
.
I confirm that I have requested an English language version of this document, a
French language version being available.
Daté ce ______ ième jour de __________________________ 20____
Dated this ______ day of ____________________________ 20 ____
Signature: ________________________________________________
Signature: ________________________________________________
Name: ___________________________________________________
(please print)
Mail this form and all cheques to:
Prénom, nom: _____________________________________________
(lettres moulées)
RANDONNÉE AVENTURE, PO BOX 26541, RPO QUEEN MARY, MONTRÉAL QC H3X 4B1