1. MOMC-MD Membership Application

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* 3. Please provide information for each family member:

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* 4. Contact Information:

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* 6. I would like to participate in these activities:

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* 7. The Mosaic Outdoor Mountain Club of Maryland is an all volunteer club. We need your help with leadership and administrative roles to ensure the success of the club. Volunteering is a great way to meet people and make new friends. Please consider volunteering for the positions shown. Select the positions you feel you could be of most assistance.

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* 8. ACKNOWLEDGEMENT TO ABIDE BY PRINCIPLES, PURPOSES AND BY-LAWS OF MOMC-MD.
The purpose of the Mosaic Outdoor Mountain Club of Maryland, Inc. (MOMC-MD). is to provide the Jewish Community with outdoor group experiences, to foster the development of outdoor knowledge, and to provide a positive social environment for sharing those experiences.

It is understood that only persons aged 18 or over are permitted to join the Mosaic Outdoor Mountain Club, although anyone under age 18 may participate in its activities if accompanied by a parent or guardian aged 18 or older. Therefore, I represent that I am age 18 or older and can participate in any Mosaic Outdoor Mountain Club activity on my own.

I agree to uphold and comply with the principals, purposes and by-laws of the Mosaic Outdoor Mountain Club of Maryland.

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* 9. ACKNOWLEDGEMENT OF RELEASE OF LIABILITY
THIS DOCUMENT AFFECTS YOUR LEGAL RIGHTS. READ IT CAREFULLY.
I am aware that the activities of the Mosaic Outdoor Mountain Club of Maryland, Inc. (MOMC-MD) may be extremely hazardous, and I am voluntarily participating in these activities with knowledge of the dangers involved. In consideration of being permitted to participate by MOMC-MD, I hereby agree to accept any and all risks including but not limited to injury,permanent disability, paralysis, or death.

I understand that MOMC-MD is NOT responsible for instruction regarding safety for any of its activities and that I am responsible for my own safety and proper equipment and clothing, and that of any minors in my charge. I represent and warrant any minors in my charge, and agree to make my own decisions regarding my own safety and the safety of those in my charge while participating in the activities of Mosaic. I am not aware of any physical, medical, or health condition that would interfere with my safe participation in these activities.

I agree I will not sue, or otherwise make any claim against MOMC-MD, or any of its officers, directors,members,agents,leaders,instructors, guides, volunteers, employees, and representatives for injury, loss, or damage resulting from the negligence or other acts, however caused, by an officer, director,member, agent, leader, instructor, guide, volunteer,employee, representative, or participant in any activity of MOMC-MD or any of its groups, as a result of my participation in any activity, whether apparently dangerous or not, of MOMC-MD.

I also hereby agree to release and discharge MOMC-MD, its officers, directors, members, agents, leaders, instructors, guides, volunteers, employees, and representatives from all actions, claims or demands, for myself, my heirs, and personal representatives, for death, injury, loss, or damage resulting from my participation in any activity of MOMC-MD. The terms of this release shall also be binding as to any other persons, members of my family, including any minors, all my heirs, successors, and assigns.

If it is determined that any portion of this Release is not enforceable or valid, the remaining portions of this Release shall remain in full force and effect. I am over 18 years of age and have read this Release.

I have carefully read this agreement and fully understand its contents. I am aware this is a release of liability and a contract between myself and the Mosaic Outdoor Mountain Club of Maryland, Inc., including but not limited to its officers, directors, members, agents, leaders, instructors, guides, volunteers, employees, and representatives. I sign this of my own free will and am not under the influence of any alcohol, illegal drugs, or narcotics.

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