thomas p. morahan waterfront park* membership application · 2020-05-27 · permit# bp thomas p....
TRANSCRIPT
Permit# BP
Thomas P. Morahan Waterfront Park*
Membership ApplicationSummer 2020*
Beach Hours
11: 00am - 7: 00pm
DUE TO THE CURRENT COVID- 19 PANDEMIC, THE TOWN OF WARWICKWILL BE ISSUING PASSES TO TOWN OF WARWICK RESIDENTS ONLY
Last Name:
First Name:
Address:
City: State: Zip:
Home Phone: ( email address:
Season Pass Options: ( please check one)
CHECK PASS TYPE RESIDENT
Family Season Pass 125. 00
Senior Season Pass ( 55 and over) 25.00
Adult Season Pass ( 19- 54 yrs) 60.00
Children Season Pass ( 5- 18 yrs) 30.00
Commercial Pass ( 20 Passes) 60. 00
Replacement Pass 5. 00 ( each)
Daily Fee 8. 00
Resident Guest Fee 10. 00
Family= Mother, Father,& Children, in the same household, list names and ages below)
Applicants must provide documentation to verify residency.
Membership/Day Rates: ( 5 & under Free)
LIMITED TO 6 PASSES PER FAMILY
THERE WILL BE A FEE OF$ 10. 00 FOR EACH ADDITIONAL FAMILY MEMBER UP TO 4
Family Pass: ( pass issued for each family member, list names below)
FIRST LAST RELATION AGE
1.
2.
3.
4.
5.
6.
Additional:
Additional:
Additional:
Additional:
Signature: Date:
Please sign Hold Harmless Agreement on the back of this form
HoldHarmlessAgreement
1. Inconsiderationforreceivingpermissiontoutilizetownproperty, Iherebyrelease, wave, dischargeandcovenantnottosuetheTownofWarwick, theirofficers, agents, servants, oremployees (hereafterreferredtoasreleases) fromanyandallliability, claims, demands, actionsandcausesofactionwhatsoeverarisingoutoforrelatedtoanyloss, damage, orinjury, includingdeath, thatmaybesustainedbymeoranyofthepropertybelongingtome, whethercausedbythenegligenceofthereleases, orotherwise , whileparticipatinginsuchactivity, orwhilein, onoruponthepremiseswheretheactivityisbeingconducted.
2. Iamfullyawareoftherisksinvolvedandhazardsconnectedwithprivateactivitiesincludedinpublicvenues, andherebyelecttovoluntarilyparticipateinsaidactivitywithfullknowledgethatsaidactivitymaybehazardoustomeandmyproperty. Ivoluntarilyassumefullresponsibilityforanyrisksofloss, propertydamageownedbyme, asresultofbeingengagedinsuchanactivity, whethercausedbythenegligenceofthereleasesorotherwise.
3. Ifurtherherebyagreetoindemnifyandholdharmlessthereleasesforanyloss, liability, damageorcost, includingcourtcostsandattorneyfees, thattheymayincurduetomyparticipationinsaidactivity, whethercausedbymynegligenceofthereleasesorotherwise.
4. IunderstandthattheTownofWarwickdoesnotmaintainanyinsurancepolicycoveringanycircumstancearisingfrommyparticipationinthiseventoranyactivityassociatedwithorfacilitatingthatevent. Assuch, IamawarethatIshouldreviewmypersonalinsuranceportfolio.
5. Itismyexpressintentthatthiswaiverofliabilityandholdharmlessagreementshallbindthemembersofmyfamilyandspouse, ifIamalive, andmyheirs, assignsandpersonalrepresentative, ifIamdeceased, andshallbedeemedasarelease, waiver, dischargeandcovenantnottosuetheabovenamedreleases. IherebyfurtheragreethatthiswaiverofliabilityandholdharmlessagreementshallbeconstruedinaccordancewiththelawsoftheStateofNewYork.
6. Insigningthisrelease, IacknowledgeandrepresentthatIhavereadtheforegoingwaiverofliabilityandholdharmlessagreement, understandit, andsignisvoluntarilyasmyownfreeactanddeed, nooralrepresentatives, statements, orinducements, apartfromtheforegoingwrittenagreement, havebeenmade; Iamatleast18yearsofageandfullycompetent; andIexecutethisreleaseforfull, adequateandcompleteconsiderationfullytobeboundbythesame.
InWitnessthereof, Ihereuntosetandsealonthis ____ dayof __________, ____
Witness Applicant