CAPE COD CORVETTE CLUB APPLICATION DATE: ______________ MEMBERSHIP APPLICATION FORm Please mail completed form to Cape Cod Corvette Club , Membership-Chair. You will be invited to a monthly meeting, and meet the Committee Chair. Once approved, you can mail your check to: Treasurer, ℅ Cindy Mason 6 Gray Birch Rd. East Sandwich, MA 02537
ANNUAL MEMBERSHIP DUES
NEW MEMBER: $57.50 / person - Includes name badge YEARLY RENEWAL: $50 / person
MEMBERSHIP ALLOWS FOR VOTING RIGHTS AT ALL MEETINGS, ANDCLUB PAYMENT OF PORTION OF CLUB EVENTS (Ie: Christmas Party, Summer Clambake, etc.)
MEMBER #1: ________R____bob____________________________________ DAY/MONTH BIRTHDAY:____________ EMAIL: _____________________________________________________ CELL PHONE: ___________________________
MEMBER #2: ________________________________________________ DAY/MONTH BIRTHDAY:____________EMAIL: _____________________________________________________ CELL PHONE: ___________________________
ARE YOU A MEMBER OF THE NATIONAL CORVETTE MUSEUM (NCM) ? Yes_____ No_____
MAILING ADDRESS: __________________________________________ HOME PHONE: _________________CITY/TOWN: ________________________________________________ STATE: ______ ZIP: ______________
CORVETTE YEAR: ________ COUPE: _________ CONVERTIBLE: _________ COLOR: ___________________PLATE #: ________________________________CORVETTE YEAR: ________ COUPE: _________ CONVERTIBLE: _________ COLOR: ___________________PLATE #: ________________________________CORVETTE YEAR: ________ COUPE: _________ CONVERTIBLE: _________ COLOR: ___________________PLATE #: ________________________________OF RISK AND HOLD HARMLESS AGREEMENT:I hereby acknowledge that I have voluntarily chosen to participate in the activities of the Cape Cod Corvette Club. I recognize that the activities involve risk of injury and I agree to accept any and all risks associated with them, including but not limited to property damage or loss, minor bodily injury, severe bodily injury and death. Furthermore, I recognize that participation in the Club activities involves activities and risks incidental thereto, including but not limited to, travel to and from meetings, Club events, Club cruises, Club classes, Club car shows, and the possible reckless conduct of other participants. I am voluntarily participating in the activities with the knowledge of the risks involved and hereby agree to accept any and all inherent risks of property damage, bodily injury, or death. In consideration of my participation in the activities and to the fullest extent permitted by law, I agree to indemnify, defend and hold the Cape Cod Corvette Club, its officers, directors, employees, agents, volunteers and assigns from and against all claims arising out of or resulting from my participation in activities. “Claim” as used in the agreement means any financial loss, claim, suit, action, damage, or expense, including but not limited to attorney’s fees, attributable to bodily injury, sickness, disease or death, or injury to or destruction of tangible property including loss of use resulting there from. In addition, I hereby voluntarily hold harmless the Cape Cod Corvette Club, its officers, directors, employees, agents, volunteers and assigns from any and all claims, both present and future, that may be made by me, my family, my estate, heirs or assigns. I also understand that the Cape Cod Corvette Club does not provide any medical or dental insurance or life insurance to cover bodily injury, illness or death, nor insurance for personal property damage or loss, nor insurance for liability arising out of my negligent acts or omissions; and I acknowledge that I am completely responsible for my own insurance to cover these expenses. I further understand that this acknowledgement of risk and hold harmless agreement is intended to be as broad and inclusive as permitted by the laws of the State of Massachusetts and that if any portion hereof is held invalid, I agree that the balance shall, notwithstanding, continue in full legal force and effect. I AGREE THAT THIS ACKNOWLEDGEMENT OF RISK AND HOLD HARMLESS AGREEMENT IS EFFECTIVE FOR AS LONG AS I AM A MEMBER OF THE CAPE COD CORVETTE CLUB.
_________________________________________________________________________ DATE: _________________________SIGNATURE OF APPLICANT / PRINTED NAME
_________________________________________________________________________ DATE: _________________________SIGNATURE OF APPLICANT / PRINTED NAME
ANNUAL MEMBERSHIP DUES
NEW MEMBER: $57.50 / person - Includes name badge YEARLY RENEWAL: $50 / person
MEMBERSHIP ALLOWS FOR VOTING RIGHTS AT ALL MEETINGS, ANDCLUB PAYMENT OF PORTION OF CLUB EVENTS (Ie: Christmas Party, Summer Clambake, etc.)
MEMBER #1: ________R____bob____________________________________ DAY/MONTH BIRTHDAY:____________ EMAIL: _____________________________________________________ CELL PHONE: ___________________________
MEMBER #2: ________________________________________________ DAY/MONTH BIRTHDAY:____________EMAIL: _____________________________________________________ CELL PHONE: ___________________________
ARE YOU A MEMBER OF THE NATIONAL CORVETTE MUSEUM (NCM) ? Yes_____ No_____
MAILING ADDRESS: __________________________________________ HOME PHONE: _________________CITY/TOWN: ________________________________________________ STATE: ______ ZIP: ______________
CORVETTE YEAR: ________ COUPE: _________ CONVERTIBLE: _________ COLOR: ___________________PLATE #: ________________________________CORVETTE YEAR: ________ COUPE: _________ CONVERTIBLE: _________ COLOR: ___________________PLATE #: ________________________________CORVETTE YEAR: ________ COUPE: _________ CONVERTIBLE: _________ COLOR: ___________________PLATE #: ________________________________OF RISK AND HOLD HARMLESS AGREEMENT:I hereby acknowledge that I have voluntarily chosen to participate in the activities of the Cape Cod Corvette Club. I recognize that the activities involve risk of injury and I agree to accept any and all risks associated with them, including but not limited to property damage or loss, minor bodily injury, severe bodily injury and death. Furthermore, I recognize that participation in the Club activities involves activities and risks incidental thereto, including but not limited to, travel to and from meetings, Club events, Club cruises, Club classes, Club car shows, and the possible reckless conduct of other participants. I am voluntarily participating in the activities with the knowledge of the risks involved and hereby agree to accept any and all inherent risks of property damage, bodily injury, or death. In consideration of my participation in the activities and to the fullest extent permitted by law, I agree to indemnify, defend and hold the Cape Cod Corvette Club, its officers, directors, employees, agents, volunteers and assigns from and against all claims arising out of or resulting from my participation in activities. “Claim” as used in the agreement means any financial loss, claim, suit, action, damage, or expense, including but not limited to attorney’s fees, attributable to bodily injury, sickness, disease or death, or injury to or destruction of tangible property including loss of use resulting there from. In addition, I hereby voluntarily hold harmless the Cape Cod Corvette Club, its officers, directors, employees, agents, volunteers and assigns from any and all claims, both present and future, that may be made by me, my family, my estate, heirs or assigns. I also understand that the Cape Cod Corvette Club does not provide any medical or dental insurance or life insurance to cover bodily injury, illness or death, nor insurance for personal property damage or loss, nor insurance for liability arising out of my negligent acts or omissions; and I acknowledge that I am completely responsible for my own insurance to cover these expenses. I further understand that this acknowledgement of risk and hold harmless agreement is intended to be as broad and inclusive as permitted by the laws of the State of Massachusetts and that if any portion hereof is held invalid, I agree that the balance shall, notwithstanding, continue in full legal force and effect. I AGREE THAT THIS ACKNOWLEDGEMENT OF RISK AND HOLD HARMLESS AGREEMENT IS EFFECTIVE FOR AS LONG AS I AM A MEMBER OF THE CAPE COD CORVETTE CLUB.
_________________________________________________________________________ DATE: _________________________SIGNATURE OF APPLICANT / PRINTED NAME
_________________________________________________________________________ DATE: _________________________SIGNATURE OF APPLICANT / PRINTED NAME
CAPE COD CORVETTE CLUB APPLICATION DATE: ______________MEMBERSHIP APPLICATION FORMPlease mail completed form to Cape Cod Corvette Club c/o Jim Tassinari, Membership-Chair, 20 Old Carriage Rd. Harwich, MA 02645. You will invited to a monthly meeting, and meet the Committee Chair. Once approved, you can mail your check to: Treasurer, Cindy Mason 6 Gray Birch Rd. East Sandwich, MA 02537ANNUAL MEMBERSHIP DUESNEW MEMBER: $57.50 / person - Includes name badge YEARLY RENEWAL: $50 / personMEMBERSHIP ALLOWS FOR VOTING RIGHTS AT ALL MEETINGS, ANDCLUB PAYMENT OF PORTION OF CLUB EVENTS (Ie: Christmas Party, Summer Clambake, etc.)MEMBER #1: ________________________________________________ DAY/MONTH BIRTHDAY:____________ EMAIL: _____________________________________________________ CELL PHONE: ___________________________MEMBER #2: ________________________________________________ DAY/MONTH BIRTHDAY:____________ EMAIL: _____________________________________________________ CELL PHONE: ___________________________ARE YOU A MEMBER OF THE NATIONAL CORVETTE MUSEUM (NCM) ? Yes_____ No_____MAILING ADDRESS: __________________________________________ HOME PHONE: _________________ CITY/TOWN: ________________________________________________ STATE: ______ ZIP: ______________CORVETTE YEAR: ________ COUPE: _________ CONVERTIBLE: _________ COLOR: ___________________ PLATE #: ________________________________CORVETTE YEAR: ________ COUPE: _________ CONVERTIBLE: _________ COLOR: ___________________ PLATE #: ________________________________CORVETTE YEAR: ________ COUPE: _________ CONVERTIBLE: _________ COLOR: ___________________PLATE #: ________________________________OF RISK AND HOLD HARMLESS AGREEMENT:I hereby acknowledge that I have voluntarily chosen to participate in the activities of the Cape Cod Corvette Club. I recognize that the activities involve risk of injury and I agree to accept any and all risks associated with them, including but not limited to property damage or loss, minor bodily injury, severe bodily injury and death. Furthermore, I recognize that participation in the Club activities involves activities and risks incidental thereto, including but not limited to, travel to and from meetings, Club events, Club cruises, Club classes, Club car shows, and the possible reckless conduct of other participants. I am voluntarily participating in the activities with the knowledge of the risks involved and hereby agree to accept any and all inherent risks of property damage, bodily injury, or death. In consideration of my participation in the activities and to the fullest extent permitted by law, I agree to indemnify, defend and hold the Cape Cod Corvette Club, its officers, directors, employees, agents, volunteers and assigns from and against all claims arising out of or resulting from my participation in activities. “Claim” as used in the agreement means any financial loss, claim, suit, action, damage, or expense, including but not limited to attorney’s fees, attributable to bodily injury, sickness, disease or death, or injury to or destruction of tangible property including loss of use resulting there from. In addition, I hereby voluntarily hold harmless the Cape Cod Corvette Club, its officers, directors, employees, agents, volunteers and assigns from any and all claims, both present and future, that may be made by me, my family, my estate, heirs or assigns. I also understand that the Cape Cod Corvette Club does not provide any medical or dental insurance or life insurance to cover bodily injury, illness or death, nor insurance for personal property damage or loss, nor insurance for liability arising out of my negligent acts or omissions; and I acknowledge that I am completely responsible for my own insurance to cover these expenses. I further understand that this acknowledgement of risk and hold harmless agreement is intended to be as broad and inclusive as permitted by the laws of the State of Massachusetts and that if any portion hereof is held invalid, I agree that the balance shall, notwithstanding, continue in full legal force and effect. I AGREE THAT THIS ACKNOWLEDGEMENT OF RISK AND HOLD HARMLESS AGREEMENT IS EFFECTIVE FOR AS LONG AS I AM A MEMBER OF THE CAPE COD CORVETTE CLUB._________________________________________________________________________ DATE: _________________________ SIGNATURE OF APPLICANT / PRINTED NAME_________________________________________________________________________ DATE: _________________________ SIGNATURE OF APPLICANT / PRINTED NAME
LUKE'S SUPER LIQUOR STORES
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