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                                                        MEMBERSHIP APPLICATION 

                            

Type of Membership:   __ Individual    __ Family    /       __ New Member   __ Renewing Member

Name _________________________________________________________Birthdate____________

Name__________________________________________________________Birthdate____________

Address______________________________________ City ___________State ______ Zip _________

Phone Number__________________________

Email Address_________________________________________(ride schedules are sent by email only)

Please note:The membership year runs from January 1 through December 31.

Membership Dues:            Individual /  Family :    $20.00                     $30.00


If you join from July 1 - December 31
you may subtract $10.00
                                                                     - $_______                - $________


If you would like to make a donation
to SAMBA, please indicate here.                     + $_______               + $________

                                                  TOTAL PAID   $_______                  $________

Make check payable to SAMBA and mail to:  SAMBA, 3113 S. BECK DR, TUCSON, AZ  85730
                                                                

                             WAIVER, RELEASE, AND ASSUMPTION OF RISKS

        I/we hereby waive, release and discharge the Southern Arizona Mountain Bike Association (SAMBA) and its officers, ride leaders,volunteers, employees, organizers, sponsors, members, and ride participants from any and all claims for personal injury, property damage,or death resulting from my/our participation in any SAMBA event.I/we acknowledge that mountain biking is a high-risk sport. I/we realize there are certain dangers inherent in the sport of mountain biking, and I/we assume these risks with the full understanding that serious
injuries and even death may result from my/our participation in any SAMBA event. I intend this release to discharge the above-named from any and all liability arising from or connected in any way with my/our participation in any event, even though that liability may result from the negligence or carelessness of the above named .I/we certify that my/our bicycle is suitable for safe use in all events, that I/we are in good physical condition, and that I/we are able to complete the event.I/we agree to wear a bicycle helmet properly adjusted and fastened and approved by SNELL or ANSI.I/we agree to obey all traffic laws and other laws at all times during all events .I/we have read this waiver and release and fully understand its terms and agree that it shall be binding on my/our heirs and assigns.I/we consent to emergency care at my own expense if injured or ill .Furthermore, I/we are willing to abide to the Bylaws and Code of Ethics of SAMBA

.____________________________________________________________________________________

Signature                                                                                                           Date

____________________________________________________________________________________

Signature                                                                                                           Date