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Tidewater Blacksmith's Guild Inc.
Membership Application Form
Please fill out the Membership Application and Waiver and return it to:
Tidewater Blacksmith's Guild Inc., Treasurer.
Name: Age: Date____________
Address:
City: State:
ZIP:
Home #: ( ) Cell #: ( )
Work #:( ) Emergency#:( ) __
Emergency Contact Name Phone #_______________________
Email address: @ ___
how did you hear about the guild __________________________________________________
What is your occupation? ________________________
Do you have previous blacksmith experience, if so please describe
Are you a member of any Blacksmith Organization? (ABANA)
Do you have your own shop?
What are your expectations of the Guild? (What would you like to make or learn?)
__________________________________________________________________
Are you willing to participate in guild activities, such as educational shows? And
Demonstrations?
How is your general health? Do you have any physical restrictions? _________
___________________________________________
Note: TBG encourages children less than 18 years of age to attend any TBG Function.
All children must be accompanied by a parent or guardian.
Return application and signed waiver with $25.00 to Tidewater Blacksmith's Guild Inc., Treasurer.
Your membership is appreciated and important to TBG
RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND HOLD HARMLESS AGREEMENT
READ BEFORE SIGNING
In consideration of being allowed to participate as a volunteer or in any way in the TIDEWATER BLACKSMITH’S GUILD, INC., (hereinafter referred to as TBG), its related events and activities,
I________________________________, the undersigned, acknowledge, appreciate and agree that:
1. TBG events and activities pose a significant risk of injury or death to the participants. These risks include but are not limited to the following: sprains, strains, fractures, heat or fire injuries, cuts, over-use syndrome injuries, animal bites and stings, contact with poisonous plants, accidents involving hot or molten metal, fire, hammer blows, sharp blades, potentially dangerous machinery and equipment and the potential for permanent paralysis and death. While particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury or death does exist; and,
2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS OF INJURY OR DEATH, BOTH KNOWN AND UNKNOWN, EVEN IF ARISING FROM THE NEGLIGENCE OF THE “RELEASEES” (the term “Releases” is defined below) or other, or through no fault of myself or anyone else, because of the nature of the activity in which I am going to be engaged, and assume full responsibility for my participation as a participant or volunteer in TBG activities or events; and,
3. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY WAIVE AN RELEASE ANY AND ALL RIGHTS TO MAKE A CLAIM AGAINST TIDEWATER BLACKSMITH’S GUILD, INC., its board of directors, officers, officials, agents and/or employees, the applicable, owners, and leasors of premises used to conduct TBG activities or events (hereinafter known as the “Releases”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law, and furthermore, I agree for myself and on behalf of my heirs, assigns, personal representative and next of kin TO INDEMNIFY AND HOLD HARMLESS ALL THE FOREGOING from any claims which I might make or which might be made on my behalf by other or which might be made against me by others, arising from my participation in TBG activities or events.
4. I further state that I am in proper physical condition to participate in TBG activities
Or events and am_____years of age.
5. That should any provision of this Waiver and Release of Liability, Assumption of Risk and Hold Harmless Agreement be held void or unenforceable, the remaining provisions thereof shall still be of full force and effect;
I HAVE READ THIS WAIVER AND RELEASE OF LIABILITY, ASSUMPTION OF RISK AND HOLD HARMELSS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
FURTHERMORE, BY SIGNING THIS WAIVER AND RELEASE, I UNDERSTAND THAT I AM GIVING UP, (WAIVING AND RELEASING) ANY RIGHT I MIGHT HAVE TO SUE OR MAKE A CLAIM WHICH I MIGHT HAVE OR WHICH MIGHT SUBSEQUENTLY ARISE OR OCCUR AGAINST TIDEWATER BLACKSMITH’S GUILD, IN., ITS BOARD OF DIRECTORS, OFFICERS, OFFICIALS, AGENTS AND/OR EMPLOYEES, THE PARTICIPATS, OTHER VOLUNTEERS, THE SPONSORING AGENCIES, SPONSORS, ADVERTISERS, AND IF APPLICABLE, OWNERS AND LESSORS OF PREMISES USED TO CONDUCT TBG EVENTS OR ACTIVITIES, AND THAT IAM INDEMNIFYING AND HLDING HARMLESS THE “RELEASEES” FROM ANY CLAIMS WHICH I MIGHT MAKE OR WHICH MIGHT BE MADE ON MY BEHALF BY OTHERS OR WHICH MIGHT BE MADE AGAINST ME BY OTHERS, ARIGINS FROM MY PARTICIPATION IN TBG EVENTS OR ACTIVITIES. IT IS MY INTENT TO GIVE UP THOSE RIGHTS AND PROVIDE THE HOLD HARMLESS AGREEMENT, AND I DO SO KNOWINGLY AND VOLUNTARILY.
X___________________________DOB____________DATE SIGNED_______
VOLUNTEER’S/PARTICIPANT’S SIGNATURE
X______________________________________________ __________
PERSON TO CONTACT IN CASE OF EMERGENCY & PHONE NUMBER
X______________________________________________ __________
WITNESS DATE SIGNED