Waupaca Curling Club

Member Sign-up

REGISTRATION FORM FOR THE 2016-2017 CURLING SEASON

STEP 1 OF 3: Enter registration details

Note that all required fields are marked with **


Enter Contact Details:

First Name: **
Middle Name:
Last Name: **
Gender: **
Address: **

City: **
Province/State: **
Postal/Zip Code: **
Country: **
Home Phone: **
Mobile Phone:
Work Phone:
Ext.:
Member Since: **
Years Curling Experience: **
Email:

Please enter your email address here. Email is the primary method used to communicate with our members and is only used for that purpose. If you do not have an email address please leave this field blank.

Re-enter Email:
Emergency Contact (If youth, enter parent): **
Emergency Contact Phone Number: **
Date of Birth: **
Youth members are required to enter their full date of birth including the year. If you want to take advantage of any available age discounts you must enter your full date of birth including the year.

Consent to Release Information, Privacy Policy and Anti-Spam Policy: **

I hereby consent to the use of the personal information provided above by the Curling Club administration. Only my name and phone numbers will be listed in the membership directory and/or website for general member use. This information is intended for the sole use of Curling Club and will not be shared outside the Curling Club.


Injury Waiver: **

ADULT PARTICIPANT RELEASE FORM

Adult Release Form

MINOR PARTICIPANT RELEASE FORM 

Minor Release Form

            The undersigned hereby makes the following representations: (i) that the undersigned understands that the sport of curling is played on ice and requires physical fitness; (ii) that the undersigned possesses such physical fitness; and (iii) that the undersigned understands that the risks of participating in any curling activity could involve serious injury or death.

             In consideration of being allowed access to the Ice House (as defined below) as a participant in any curling activity in the Ice House, I, the undersigned, for myself and my estate, successors, heirs, beneficiaries, administrators, trustees, representatives, and attorneys do hereby remise, release, acquit, and forever discharge (i) the Waupaca Curling Club a Wisconsin 501(c)3 non-stock corporation (the “Club”); (ii) the United States Curling Association, Inc. (“USCA”); (iii) the Wisconsin State Curling Association (“WSCA”); (iv) the respective successors and assigns or each of the Club, USCA, and WSCA and (v) the respective employees, officers, and directors, but only while acting in their capacity as such, of each of the Club, USCA, and WSCA (collectively, the “Releasees”) from any and all actions, causes of action, claims, demands, and liabilities, both in law and equity for damages and any court costs and legal expenses and fees associated therewith in respect of physical, mental, and bodily injury occurring to me while participating in any curling activity in the Ice House prior to the Expiration Date (as defined below); provided, however, that in the event such injury was caused, in whole or in part, by the willful, intentional, reckless, or grossly negligent action or failure to take action of any Releasee, such Releasee shall not be so remised, released, acquitted, or discharged hereby; and provided, further, that nothing herein shall be deemed to limit or exclude any action, cause of action, claim, demand, liability, payment, reimbursement, other benefit, or any court costs or legal expenses and fees that I or my estate, successors, heirs, beneficiaries, administrators, trustees, representatives, or attorneys might have or seek against (a) the Club’s “Participant Medical Accident” insurance coverage, (b) any other participant participating in any curling activity in the Ice House, or (c) against any other person or entity other than a Releasee.

             The Ice House shall mean the single room containing 4 sheets of ice in which the sport of curling is played in the building located at 216 South Franklin Street, Waupaca, WI owned and operated by Club. The Expiration Date shall mean the date which is one (1) calendar year after the date this Release is executed below.

  I certify that I am at least eighteen (18) years of age and have the legal capacity to execute this Participant Release on my own behalf.

  I hereby revoke any and all releases of liability, waivers, and indemnifications previously executed by me in favor of any of the Releasees.

 

            BEFORE SIGNING BELOW, I WAS GIVEN THE OPPORTUNITY TO READ THIS PARTICIPANT RELEASE AND TO CONSULT WITH AN ATTORNEY AS TO ITS SIGNIFICANCE. BY SIGNING BELOW, I UNDERSTAND THAT I AM WAIVING SIGNIFICANT RIGHTS. I UNDERSTAND THE MEANING OF THIS PARTICIPANT RELEASE AND THE RIGHTS I AM WAIVING. NOTWITHSTANDING THE FOREGOING, I HAVE CHOSEN, OF MY OWN FREE WILL, TO EXECUTE THIS PARTICIPANT RELEASE.

 


Registration Selection: **

Select the membership type first by checking on the approproiate round checkbox. If registering for a membership type that also has league selections please check all the square checkboxes for the leagues in which you wish to play. Please show all team member names for choose your own leagues, each team member must submit their own form. Not on a team? Write assign for the other team members.

League Curling

Adult Full Membership ($290 before discounts, 5.5% sales tax included) - This membership includes:

  • Leagues: May curl or sub in all club leagues. Men may curl in as many as 5 leagues and Women may curl in 4 leagues.
  • Full access to all Club events: Roar’n Rookie Bonspiel, Friday night Curl and Fish Fry, Reversed Raffle, Holiday and Packer parties, Club bonspiels, Home and Home, and many more.
  • Full voting rights and opportunities to serve as a Board member as well as Club President and Vice-President.
  • Receive a subscription to the US Curling News Magazine

IF SELECTING THIS, PLEASE CHECK WHICH LEAGUE(S) YOU ARE OR ARE INTERESTED IN PLAYING IN:

Sunday Mixed Curling - four person teams consisting of two men and women with the throwers alternating in gender.

If you know who is on your team, or some of the people on your team, enter them here.  If you are signing up as an indivdual, enter NEED for the positions.  If you have most of a team but need one or two additional players, enter NEED in the positions you need players for.  If playing with 5 or more players, enter 4 of the players and let the league chair know.

Skip: ** 
Vice-Skip: ** 
Second: ** 
Lead: ** 

Monday Night Open - league teams can consist of any gender combination.  Players are able to throw stones in any order regardless of their gender.

If you know who is on your team, or some of the people on your team, enter them here.  If you are signing up as an indivdual, enter NEED for the positions.  If you have most of a team but need one or two additional players, enter NEED in the positions you need players for.  If playing with 5 or more players, enter 4 of the players and let the league chair know.

Skip: ** 
Vice-Skip: ** 
Second: ** 
Lead: ** 

Tuesday Night Women's League

If you know who is on your team, or some of the people on your team, enter them here.  If you are signing up as an indivdual, enter NEED for the positions.  If you have most of a team but need one or two additional players, enter NEED in the positions you need players for.  If playing with 5 or more players, enter 4 of the players and let the league chair know.

Skip: ** 
Vice-Skip: ** 
Second: ** 
Lead: ** 

Wednesday Night Men's League

If you know who is on your team, or some of the people on your team, enter them here.  If you are signing up as an indivdual, enter NEED for the positions.  If you have most of a team but need one or two additional players, enter NEED in the positions you need players for.  If playing with 5 or more players, enter 4 of the players and let the league chair know.

 

Skip: ** 
Vice-Skip: ** 
Second: ** 
Lead: ** 

Thursday Night Men's League

If you know who is on your team, or some of the people on your team, enter them here.  If you are signing up as an indivdual, enter NEED for the positions.  If you have most of a team but need one or two additional players, enter NEED in the positions you need players for.  If playing with 5 or more players, enter 4 of the players and let the league chair know.

Skip: ** 
Vice-Skip: ** 
Second: ** 
Lead: ** 

Lifetime Member/No Curling - If you have a lifetime membership at the club, but are currently not curling in any league, select this option.

 

Casual Curler ($125, no discounts available, 5.5% sales tax included) - This membership includes:

  • Leagues: May ONLY curl in Wednesday Morning Casual League and Friday Fun Night.
  • Full access to all Club events: Roar’n Rookie Bonspiel, Friday night fun night, Reversed Raffle, Holiday and Packer parties, Club bonspiels and many more.
  • Have no voting privileges.

  • Can not sub/spare on other league nights.

IF SELECTING THIS OPTION, PLEASE CHECK THE BOX BELOW FOR WEDNESDAY AM LEAGUE

Wednesday AM Casual Curling - non-competitive league without any formal teams.  This league is open to both Men and Women.


Special Membership Options

Junior/High School Member ($40, 5.5% sales tax included)

  • Ages 14-18 (Grades 9-12).  Can play and sub(spare) in adult leagues at league chair's discretion.

Social Curling Member ($30, 5.5% sales tax included) - This membership includes:

  • Full access to the Club and its social events, but have NO curling or voting privileges.

Youth Curling Member ($40, 5.5% sales tax included)

  • Ages 10-14 (5th through 8th grade).
  • Includes membership in USCA Jr. Merit Program, a $3 value.

Additional Registration Options

Locker Rental ($20) - Covers rental of one locker for the season.

Replacement Name Tag - ($6)  Check if you need a replacement name tag.  Do not check if a new curler.  New curlers will get a name tag free.


Registration Discount Options

1-2-3 Volunteer Plan Discount ($50 off dues) - Check if you are participating in the 1-2-3 Volunteer Plan.  Do not check if you are also checking the new member discount.  123 Volunteer Plan Description

New Member Discount - ($90 off dues) Check if you are a new members to the Waupaca Curling Club, or were a member but have not curled at the club in the previous five years.  New members recieve a discounted rate of $200 for the first year.

2nd Curler in Household ($30 off dues) - Check if you are the second curler in household.  Only one 2nd curler discount per household.  Do not check if you are also checking the new member discount.

Snowbird Discount – ($125 off dues) Half season discount for Adult Full Members only. This allows members full curling privileges until January 15th. No curling privileges after this date, no exceptions.



Registration Accuracy Confirmation: **

I hereby confirm that the information I have entered on this form is correct and true. I understand that if I have intentionally entered false information in this form to receive discounts that do not apply to me there will be a $25 administration charge on top of the outstanding membership dues owed.



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