"*" indicates required fields

Please read the Warning to Skiers and Assumption of Risk Agreement before signing this form or using your pass. Your signature indicates you have read and understand the notice, warning to skiers and assumption of risk detailed below.

NOTICE: SKIERS – are governed by the New York State Safety in Skiing Code (Article 18, of the NYS General Obligations law). Before accepting this pass or allowing this pass to be affixed to your person, your attention is directed to a posted “WARNING TO SKIERS” which is printed below and where passes are purchased. New York Law requires you to seek out, read, review and understand the “Warning to Skiers” before you decide to participate in the sport of skiing.

WARNING TO SKIERS: Nordic skiing, like many other sports, contains inherent risks including, but not limited to the risk of personal injury including, catastrophic injury, or death, or property damage, which may be caused by variations in terrain or weather conditions; or, surface or subsurface snow, ice, bare spots or areas of thin cover, moguls, ruts, bumps; or other persons using the facilities; or rocks, forest growth, debris, branches, trees, roots, stumps; or, other natural objects or man-made objects that are incidental to the provision or maintenance of a ski facility in New York State. New York Law imposes a duty on you to become apprised of, and understand, the risks inherent in the sport of skiing, which are set forth above, so that you make an informed decision whether to participate in skiing notwithstanding the risks. New York law also imposes additional duties upon you, to which you must adhere, for the purpose of avoiding injury caused by any of the risks inherent in skiing. If you are not willing to assume all of these risks and abide by these duties, you must not participate in skiing at this area.

ASSUMPTION OF RISK AGREEMENT: I have read, reviewed and understand the WARNING TO SKIERS printed above. In signing this application and receiving the Pass, I signify that I am aware of and understand the risks inherent in the sport of skiing and that I am accountable for my action as set forth on the WARNING TO SKIERS signs. I agree that this acknowledgement shall be for the entire term of the pass received. For the entire term, I relinquish my right to a refund of the purchase price of the pass purchased, WHICH IS ALSO FACTORED INTO THE COST OF ADK MEMBERSHIP, that is allowable under the Safety in Skiing Code for those persons unwilling to ski because of the risks of the sport or the duties imposed upon skiers by law.

Waiver and Release of Responsibility: I, by my signature below, understand that I am voluntarily participating in outdoor sports activities at Adirondack Mountain Club’s Cascade Welcome Center during the current winter season. I understand this activity has certain risks, and I acknowledge for myself, my heirs, executors and assigns, that I understand such risks.

I release and forever discharge Adirondack Mountain Club, Inc., its trustees, officers and employees from any and every liability, claim or damage of any kind, nature or description, and I likewise and forever discharge Adirondack Mountain Club, Inc., it’s officers and employees from any and every liability, claim or damage on any kind, nature or description occurring to me or any minor child accompanying me.

I further hereby agree to hold Adirondack Mountain Club, Inc. harmless, and I assume any and all risk of every kind and nature sustained by me or any minor child accompanying me by reason of my personal choice to engage in this activity with a full understanding that I willingly assume any and all damage, detriment, hurt or impairment for any cause directly connected with these activities and experiences.

Participant Name*
Date*
Emergency Contact Name*
INSURANCE COVERAGE

Participant is responsible for their own medical expenses. ADK requires that anyone participating in a program have their own medical coverage in the event that an injury occurs to the participant either before or after the program begins. The information requested below is for the primary family policy holder.

Name of Policy Holder*
IF UNDER 18 YEARS OF AGE, PARENT OR GUARDIAN MUST READ AND SIGN BELOW:

Participant and parent/s of a minor participant agree: I have carefully read, understand, and voluntarily sign this document and acknowledge that it shall be effective and binding upon me, my minor children, and other family members, my heirs, executors, representatives, and estate to the greatest extent permitted by law. I further acknowledge that the substantive laws of the State of New York govern this document and that if any portion of this document is deemed unlawful or unenforceable that it shall not affect the remaining provisions, which shall continue in full force and effect.

Parent/Guardian Name
MM slash DD slash YYYY