New Mexico Mountain Club

RELEASE OF LIABILITY

By signing below, I acknowledge that all activities sponsored or conducted by The New Mexico Mountain Club (NMMC) may be hazardous, and may result in loss, damage, or death;

With full knowledge of these dangers, I hereby agree for myself, all of my family and heirs, to RELEASE the NMMC and any of its leaders, groups, representatives or agents from liability, claims, demands or any causes of action, and NOT TO SUE OR OTHERWISE MAKE ANY CLAIM against the NMMC or any of its leaders, groups, representatives or agents whatsoever which may arise during my participation in any activities of the NMMC.

I intend this RELEASE OF LIABILITY to be effective whether or not any loss damage, injury or death RESULTS FROM NEGLIGENCE of the NMMC or any of its agents, leaders, instructors, guides, officers, directors, or representatives. I understand that negligence means a failure to do an act which a reasonable careful person would do, or the doing of an act which a reasonable careful person would not do, under the same or similar circumstances, to protect himself, herself or others from injury or death.

I understand that NMMC leaders have no special knowledge or training and that I agree to be solely responsible for my own safety and to take every precaution to provide for my own safety and well-being while participating in activities of the NMMC. I also hereby certify that I am in good health and that there are no medical reasons which could threaten my safety or the safety of others during this activity.

Name (please print) _______________________________________________________________________

Signature ____________________________________________ Date_______________________________

IF UNDER 18 YEARS OF AGE, PARENT OR GUARDIAN MUST READ AND SIGN BELOW:

I am the legal guardian of the above minor and have read the above RELEASE. I hereby consent to the terms of the RELEASE on behalf of the named minor, and give my consent to the participation of the above named minor in all activities of the NMMC on the terms stated.

Signature ____________________________________________ Date ________________________________
[Parent or legal guardian]

PERSONAL DATA. Please fill out for completion of the Club’s records. Please print.

Are you currently a member of the New Mexico Mountain Club? Yes [ ] No[ ]

Mailing address ___________________________________________________________________

_________________________________________________________________________________

Home phone ____________________________ Work phone ______________________________

Email address ____________________________________________________________________