Professional Documents
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Email: ____________________
SIGNIFICANT OTHER:
First Name:
_________________
Name: _____________________
Name: _____________________
Name: ______________________
_________________________________________
Phone (Home):
Cell:
_________________________________
_________________________________
Vehicle 1 ________________
Vehicle 2
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I and my family are aware of the risks involved and the possible injury to
myself and family inherent in this type of activity. I hereby release the OnaLac Canoe Club and Sudbury Integrated Nickel Operations (a Glencore
Company) its members and agents from all liability for any injury or damages
arising from my participation in any activities organized by the Club as well as
my use of the Club facilities.
Mail or Deliver your application to: Marlene Draper
2 Carter Street, Levack, Ontario P0M 2C0 Ph: 595-2074
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Date
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Signature