READ FIRST
All 1st time applicants must attend a club meeting prior to finalizing your application. Club meetings are held the 1st
Tuesday of each month unless posted otherwise. Meeting times and locations are posted on the home page meeting link.
All 1st time applicants must submit proof of USA Water Ski membership. Either email to webmaster@goldcoastskiclub.org
or bring a copy to your first meeting.

1st time applicants may opt to download a hard copy of the membership application and either hand carry it to a meeting or
send it to the secretary. If you choose this option follow the instructions on the home page "application link."

Gold Coast Ski Club

3-Event - Show - Kneeboard - 2017 - Barefoot - Wakeboard - Hydrofoil

NEW

MEMBERSHIP xxxxxxxxxxx APPLICATION

Family: Individual:

Name:* Date:*

Address:*

City: * State:* Zip:*

Phone:* Work:

Email:* Pager/Mobile:


Date of Birth:* Name of parent or guardian (if under 18):

USA Water Ski #: Copy of card attached: or USA WS application:

Emergency Contact:* Relationships:

Phone:* Work:

________________________________________________________________________________________________

Water Sport Interests (Check all that apply)
3-Event (AWSA) Show Ski (NSS) Barefoot (ABC) Wakeboard (WKB)
Disabled (WSD) Kneeboard Hydrofoil (HYD) Other

Behind the scenes: (Select one or more items of interest!)
USA WS official Trained Driver Safety Director Level One Instructor
Organizing xxxix Eventsxxxxxiii Meetingsxxxxix Socialxxxxii Marketing
xxxxxxxxxxxxix Newsletterxxxx Websitexxxxxx Facebookxxi Instagram
Show Ski Support
Announcerxx Baby Sitter Boat Driver Choreographerxx Concessions
Constructioni Costumes ss Dock Crewi Equipment Crew Observer Pin-Puller
Sound & Music Other (s)

Do you have a boat you would like to use on Lake Lauderdale? Yes No
Boat make & model

Family Memberships:
Name: DOB: USA WS #
Copy of card attached Application enclosed
Name: DOB: USA WS #
Copy of card attached Application enclosed
Name: DOB: USA WS #
Copy of card attached Application enclosed
Name: DOB: USA WS #
Copy of card attached Application enclosed

GCSC Membership Dues (Check all that apply:
Individual Membership xxxxxxxxxxxx$230 =xx$
Spouse Membership xxxxxxxxxxxxxxx$95 =xx$
Child Active (12 -16 yrs) # xxxx $35 =x$
Child Active (Under 12) $20 # x $20 =x$
College student (up to 24 yrs.) #x $35=x$
Supporting Membership $35 =xxxxxxxxxxxxxx$
TOTAL MEMBERSHIP FEE $* xxxxxxxxxxxxx$

.  ALL members MUST sign the Release on the next page (below) ~ Parent/Guardian signature if under 18yrs.
.  Renewals are due by Jan.31st.  A 10% late fee will be assessed on delinquent members .
.  Renewals will be void on March 1st.   After March 1st, you must apply as a new member.
.  All new memberships must be approved at the monthly Board of Directors meeting.
xAnd must print out (from GCSC web site)  and bring to the meeting ----- a copy of Lake Rules-Operational policy
.  Call 954-753-6098 if you have any questions.

Forward To:  Gold Coast Ski Club  * 156 Red Water Pt., Lake Placid, Fl 33852

________________________________________________________________________________________________

Gold Coast Ski Club - MEMBER
RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT
(Revised 12-2-2008)

I, the undersigned, hereinafter referred to as “MEMBER,” hereby
agree, certify and promise as follows;

I understand and appreciate the inherent risk and danger of SERIOUS BODILY INJURY, POSSIBLE DEATH and
PROPERTY DAMAGE that exists while waterskiing and/or participating in other related recreational water sports
activities such as slalom skiing, wake boarding, tubing, trick-skiing, jumping, bare-footing, hydro-sliding, wake-surfing
or any other activity.  Such risks and dangers of SERIOUS BODILY INJURY, POSSIBLE DEATH and PROPERTY
DAMAGE, include, but are in no way limited to: \

1. Striking submerged, floating or fixed objects, including the jump ramp, lake-bottom, shoreline, docks and the risk
\of striking and/or being struck by a tow-boat or other boat.
2. Equipment failure, whether personal property or supplied by others.
3. Danger of being struck by a ski handle and/or rope while riding in tow boats as an observer or passenger.
4. Danger presented by boarding and un-boarding boats.
5. Danger presented by usage of all docks, boat ramps and shoreline.
6. Exposure to inclement weather, including lightning.
7. Exposure to extreme physical stress while waterskiing and participating in related water sports activities.

MEMBER agrees to assume and accept any and All RISK OF PERSONAL INJURY, POSSIBLE DEATH and
PROPERTY DAMAGE, including but not limited to the risks stated above, that occur or arise as a result of participating
in the activity of waterskiing and/or any other related water sports activity at The Gold Coast Ski Club.

MEMBER also accepts all responsibility for any PHYSICAL INJURY, POSSIBLE DEATH or PROPERTY
DAMAGE that may occur at or on any premises used in connection with The Gold Coast Ski Club.  This includes
the lake, real property and improvements thereon located at Mills Pond Park, 2201 NW 9th Ave., Ft. Lauderdale, FL.

For good and valuable consideration received, including the use of The Gold Coast Ski Club’s facilities, lake, land
and improvements, MEMBER with the intent of binding himself/herself, his/her spouse, heirs, legal representatives and
assigns, hereby expressly knowingly and voluntarily waives any and all claims or causes of action, including those bases
on negligence, which he/she may now or hereafter have against The Gold Coast Ski Club and any and all employees,
directors, officers, members, beneficial shareholders, agents or assigns of any of the foregoing.

MEMBER further agrees to indemnify and hold The Gold Coast Ski Club, and the employees, officers, directors,
beneficialshareholders, members, agents and assigns of any of the foregoing, harmless against any and all claims,
includingthose based on negligence, resulting from injuries or damages.

MEMBER further agrees that The Gold Coast Ski Club shall not be liable for any injuries, claims or any damage to
any member or guest, or be subject to any lawsuit, claim, demand, injury or damages, whatsoever, including without
limitation, those damages from acts of passive or active negligence on the part of GCSC, its officers, employees, agents,
other members, and/or volunteers. Member and guest(s) do hereby expressly forever release and discharge GCSC from
all such lawsuits, claims, demands, injuries, damages, actions or causes of action.  \ MEMBER and guest(s) acknowledge
that he/she has carefully read this paragraph and fully understands that this is a waiver and release of liability.

MEMBER or guest also releases The Gold Coast Ski Club from any responsibilities under Fl. Stat. 327.48 and that
member or guest assumes the responsibility of inspecting the site to ensure there is adequate protection to him/her
and that the site is suitable for safety and navigation to the member or guest. 

MEMBER has read this entire agreement, understands its meaning and consequences, is signing it freely and
voluntarily and agrees to each provision.

I have read the release and waiver of liability nd indemnity agreement above and agree to abide by the
statementscontained within. Yes No

Typing my name below constitues this agreement the same as if I were personally present and signing.
If signing for a minor, print type the minors name and type YOUR name as Parent or Guardian for the minor.

I THE UNDERSIGNED *

PRINT NAME  SIGNATURE  DATE
PRINT NAME SIGNATURE DATE
PRINT NAME SIGNATURE DATE


Comments:

xxxxxxxxxxxx
__________________________________________________________________________________________________

GCSC USE ONLY
Approved Date:             Paid: Cash / Ck#              Deposited:               USAWS ~ Copies           Application