As a Chattanooga Hiking Club member, guest, or visitor participating in Club activities, I voluntarily assume any and all risks incident to the Chattanooga Hiking Club activity described below, including any costs related to rescue or medical care, for myself and for my family members participating in this club activity, and with the intent to be legally bound, I hereby agree for myself, my family members participat-ing in this activity, my executors and administrators, to release from any and all liability for any personal injury or property damage related to the Chattanooga Hiking Club activity described below, every officer, trip organizer, member, guest, or visitor participating in this activity and any person, partnership, corporation, or other organization or association that permits the use of its real or personal property for this Chattanooga Hiking Club activity. I understand that it is my responsibility to furnish my own drinking water, food, and any first aid supplies I may require during the course of the activity described below.
Activity Description:________________________________________________________________________
Leader: ________________________________________Co-leader:__________________________________
Date of activity: ______________________
Signature_____________________Printed Name______________________Emergency Contact _________________
____________________________ __________________________________ Name______________________________
Telephone # _________________________
____________________________ __________________________________ Name______________________________
Telephone # _________________________
____________________________ __________________________________ Name______________________________
Telephone # _________________________
____________________________ __________________________________ Name______________________________
Telephone # _________________________
____________________________ __________________________________ Name______________________________
Telephone # _________________________
____________________________ __________________________________ Name______________________________
Telephone # _________________________
____________________________ __________________________________ Name______________________________
Telephone # _________________________
____________________________ __________________________________ Name______________________________
Telephone # _________________________
____________________________ __________________________________ Name______________________________
Telephone # _________________________
____________________________ __________________________________ Name______________________________
Telephone # _________________________
____________________________ __________________________________ Name______________________________
Telephone # _________________________
____________________________ __________________________________ Name______________________________
Telephone # _________________________
____________________________ __________________________________ Name______________________________
Telephone # _________________________
____________________________ __________________________________ Name______________________________
Telephone # _________________________
____________________________ __________________________________ Name______________________________
Telephone # _________________________
____________________________ __________________________________ Name______________________________
Telephone # _________________________
____________________________ __________________________________ Name______________________________
Telephone # _________________________
____________________________ __________________________________ Name______________________________
Telephone # _________________________
____________________________ __________________________________ Name______________________________