Registration Form

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INSTRUCTIONS FOR HIKERS:

1. If you need carpool to the trail head, you can only register for yourself. 2. If you drive, please provide full names of people and additional spaces open for carpool in your car. 3. Cut-off time for the registration would be 6PM of the Thursday of the hike. 4. *** Registration will be voided if incorrect information is supplied. ***

*	Required Field
First Name*:
Last Name*:
Email Address*:
Your Telephone Number (10 digits)*:
Your Current Membership Status*:	Select One-- Member - Individual Member - Family Non-member
Day of The Hike*:	Select One-- 05/25/2013 Breakneck Mtn, East Hudson, NY 05/25/2013 Kenneth Wilson State Park, Catskill, NY 06/01/2013 Palisades Interstate Park, NY/NJ
Register for Minors: (Children under age 18)
Carpool Information*:	Select One-- I am a driver. (See For Driver Only section) Yes, I need carpool assistance. No, I do not need carpool assitance.
Carpool Locations: (Check all that applies)	Queens Brooklyn Manhattan Other (specify in the Additional Information box below)
Additional Information: (Detailed location, hiking experience, etc.)
For Driver Only:
Register for Additional Hikers in The Car:
Additional Seats Available:	Select One-- 0 1 2 3 4 5 6

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CMCNY Trip Liability Release/Disclaimer Agreement

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 agree with the CMCNY Trip Liability Release/Disclaimer Agreement. 2. I will abide to the trip leaders' instructions during the hike and act responsibly not to cause inconvenience or endanger the safety of other hikers.