2014 DBC Membership Application

To apply for a 2014 Orlando Dragon Boat Club Membership, please complete the form below. If you prefer to complete the application on paper, please feel free to download, print, and submit the 2014 DBC Membership Application Pack here. By e-signing the form below, you verify that you agree with the terms contained within this application, and within the Media Release, DBC Code of Conduct, Orlando Rowing Club Waiver of Liability, and DBC Privacy Policy. Should you have any questions regarding these forms, please feel free to contact Marelize.

Name:
Address:
City:
State:
Zip Code:
Home Phone:
Work Phone:
Mobile Phone:
Email:
Date of Birth:

EXPERIENCE LEVEL (please select one, using best judgment - this is purely for informational purposes):

MEMBERSHIP FEES
*All memberships, except non-resident membership, are yearly starting January through December. Except for the non-resident membership, you may pay entire cost up front or half now and half in six months (final half would be invoiced to you when month sixth is approaching).
 $225 (2014 New Member) $225 (Renewing Member) $125 for 6 month membership

Help us get to know you!
I am joining the ODBC because (check off all that is applicable):
 Health & Fitness - I want to get in shape Social - I want to meet new people I enjoy water sports I'm a competitive athlete & want to race Other (please enter reason below:
MEDICAL (explain any medical or physical conditions you may have that may be important or relevant to your paddling experience and safety):

The ORC-DBC recommend that you consult your physician prior to participating in this activity as it may be too strenuous for certain individuals and as such, your physician should determine whether dragon boating is appropriate for you.

AGREEMENT
In becoming a member of ORC-DBC , I agree to abide by the bylaws and respect the decisions made by the team. The team and its management reserve the right to refuse renewal or terminate membership, without refund, of any individual whose presence they deem disruptive to the team. I understand that dragon boating is a water sport with inherent risk, and it is my own responsibility to consult my physician regarding any existing injuries, health risks or medical conditions, and to exercise my own judgment in the participation of any practice or race. On behalf of myself, my heirs, my personal representatives and executors, I hereby release, discharge, indemnify and hold harmless the team, the Executive Committee, any team
member or organizer of dragon boat events for any injury, damage, or loss sustained during activities. I agree on behalf of myself, my heirs, my personal representative and executors, to allow any photographs/videos taken of me for use in publicity and promotional efforts.

I hereby agree by my signature below, and in consideration of ORC-DBC allowing me to utilize ORC-DBC equipment, participate in ORC-DBC functions including club programs and festivals or otherwise participate in the paddling experience in any way related to, under or through ORC- DBC, and other good and valuable consideration, receipt and adequacy of which is hereby acknowledged, to be bound by and faithfully obey the ORC-DBC Equipment and all other Policies and Procedures and the ORC-DBC Code of Conduct, as they may exist now and as they may be adopted or changed in the future by the ORC Board of Directors in its sole discretion.

I have read this agreement, fully understand its terms, understand that I have given up substantial rights by signing it and have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid, the balance, notwithstanding, shall continue in full force.

If applicant is under the age of 18, a parent or legal guardian must sign this form.

e-signature:

email:

Amount You Will Pay:

IN AN EMERGENCY, CONTACT:

Emergency contact name:

Emergency contact telephone:

Relationship to you:

Emergency contact work phone:

 


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