First Name *:
Last Name *:
Email Address *:
Your Telephone Number (10 digits) *:
Your Current Membership Status *:
Member - Individual
Member - Family
12/10/2016 7 & 11 Mile Day Hikes / Levels B & C | Cranberry Hill / Lake Nawahunta / Silvermine Lake Loop
12/17/2016 7 Mile Day Hike / Level C | Johnsontown Circle / Lake Skenonto, Harriman State Park, NY
12/31/2016 9 Mile Day Hike / Levels C | West Mountain, Harriman State Park
01/07/2017 6 & 8 Mile Day Hikes / Levels B & C | Dunderberg Mountain, Harriman State Park
01/14/2017 15 Mile Day Hike / Level D | West Mountain, the Timp and Dunderberg Mountain Loop, Harriman State Park
01/15/2017 Annual Meeting / Spring Festival Party | St. James Episcopal Church, Elmhurst, NY
Register for Minors: (Children under age 18)
Carpool Assistance Request *:
If Driving, Additional Seats Available:
Home/Pickup Locations: (Check all that applies)
Queens, LIE/ Kissena/ Main
Queens, Downtown Flushing
Queens, Elmhurst/ Rego Park
Queens, Forest Hills
Manhattan, 62nd St./ Lexington Ave
Manhattan, (supply additional info.)
Brooklyn, (supply additional info.)
New Jersey, (supply additional info.)
Other (supply additional info.)
Additional Location Information: (Detailed location, ride arrangement, etc.)
For Driver Only:
Register for Additional Participants in The Car:
I understand that during outing(s) of which I participate under arrangements of CMCNY and its agents, certain risks and dangers may arise,
including but not limited to the hazards of traveling in the wilderness, the forces of nature, accident and illness.
In consideration of the right to participate in these outing(s), I have and do hereby assume all foreseen and unforeseen risks associated with
the outing(s) and to the fullest extent allowed by law, I will hold CMCNY, its agents, its trip leaders,
its officers and board of directors harmless from and defend them against any and all liability actions, suits, claims and demands which could arise out of the outing(s).
This Agreement shall serve as an absolute release and assumption of risk for myself and my heirs, administrators, executors, and for all members of my family including any minors accompanying me.
I represent I am in good general health, have good exercise tolerance and free of any physical and/or medical restrictions to participate in the outing(s).
I understand that neither CMCNY nor its agents, trip leaders and/or volunteers are medical providers, and medical services may not be available while I am participating in the outing(s).
The outings officially begin and end at the location designated by CMCNY, and DO NOT include carpooling, transporting, or transit to and from the outing(s).
I fully understand and acknowledge I am personally responsible for all risks associated with this travel.
By pressing the SUBMIT button, I agree that
1. I have read and agree with the CMCNY Trip Liability Release/Disclaimer Agreement.
2. I will abide to the trip leaders' instructions during the activity and act responsibly not to cause inconvenience or endanger the safety of other participants.