Application

Name: ____________________________________________________

Home Address: _____________________________________________

City: ________________________ State: _____ Zip: _____________

Home Phone: __________________ Cell Phone: __________________

E-Mail Address: ____________________________________________

Florida Address: ____________________________________________

City: ________________________ Zip: _____________

Area of carving interest: ______________________________________

___________________________________________________________

Date: ______________ Signature: __________________________

Do you have any other Carving Club Affiliations? If so, please list them

to the right! Thank you for completing this application.

The cost of membership for each year is thirty-five dollars

($35.00) per person or fifty-five dollars ($55.00) per couple.

Each applicant must read and sign the RELEASE OF LIABILITY FORM below

Please do not send cash – please pay in the form of a check or money order. Thank you!

Dues cover October 1st through September 30th

Please print and mail this completed application, liability form and dues to:

Caloosa Carvers

c/o Dom Bello

15488 SpringLine Lane

Fort Myers FL 33905

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I, ____________________________________, desire to voluntarily participate as a member of the Caloosa Carvers Club of Fort Myers Florida. I represent that I am knowledgeable of this activity and the risks of harm or personal injury to myself and others that may be associated with this activity. Having acknowledged these risks, I wish to assume them by voluntarily becoming a member of the Caloosa Carving Club and participating in the activities of the Club including but not limited to regular weekly meeting, seminars, instructional classes, show events and demonstrations.

I understand that Caloosa Carvers Club accepts no responsibility for my acts or acts of others while I am participating in any of the aforementioned activities associated with the Club.

In consideration of the Caloosa Carving Club offering this opportunity and allowing me to participate in these activities, the receipt and sufficiency of said consideration being hereby acknowledged, I hereby do release, relieve, discharge and forever hold harmless the Caloosa Carving Club, its officers, committee members, other club members, its representatives, agents, and lessors from any and all liability including but not limited to personal injury, property damage or otherwise arising out of or in connection with this activity.

By signing below I acknowledge that I have read and understand this release of Liability.

IF THE MEMBER IS NOT 18 YEARS OR OLDER THIS RELEASE MUST ALSO BE SIGNED BY THE MEMBERS PARENT OR LEGAL GUARDIAN.