<p> Outdated please visit carrollcave.org Carroll Cave Conservancy Membership Application Circle One: New or Renewal Name: ______First M. I. Last Address: ______</p><p>______</p><p>______, ______City State Zip Date of Birth: ______Phone: ______Cell Email: ______Type of Membership (Circle one)</p><p> Regular Single $15  Family (Primary) $20  Family ( Secondary) $0 (covered by Primary) If Family-secondary print Family-primary name ______ Minor $5 If Minor print Sponsor’s Name ______ Other</p><p>Amount of Dues enclosed $______</p><p>I have enclosed a completed, signed, and witnessed release. </p><p>I agree to comply with the policies and mission of the CCC as stated in the Constitution and Bylaws. Signature Date</p><p>035b5745677992e6301bafdcca196aff.doc 035b5745677992e6301bafdcca196aff.doc RELEASE FROM LIABILITY GIVEN TO CARROLL CAVE CONSERVANCY, ET AL. 2004-2005</p><p>I, ______, [Print your name] hereby affirm that I am in good health and have appropriate training and skills to participate in exploration and research activities in Carroll Cave. By signing this Release I certify that I am familiar with Carroll Cave, the entrance to Carroll Cave created by the Carroll Cave Conservancy (“CCC”) and the dangers inherent in cave research and exploration. I further certify that I have personally prepared myself for cave research and exploration activities, and have made myself familiar with appropriate rules and principles of safety associated with those activities.</p><p>I AM AWARE THAT CAVE RESEARCH AND EXPLORATION ARE HAZARDOUS ACTIVITIES, AND AM VOLUNTARILY PARTICIPATING IN THESE ACTIVITIES WITH KNOWLEDGE OF THE DANGER INVOLVED AND HEREBY AGREE TO ACCEPT ANY AND ALL RISKS OF INJURY OR DEATH.</p><p>I understand that all research, exploration or other activities on the property located at the Fry/Danuser farm in Camden County, Missouri, Township 20, section 14, approximately 3 miles southeast of Montreal, Missouri in which I will participate are intended to provide scientific and technical information about Carroll Cave for use by the Carroll Cave Conservancy and are not intended to be educational or to teach safety rules. I understand that others involved in these activities will not serve as guardians of my safety. I understand and agree to furnish my own equipment and other materials that may be required in these activities, including but not limited to safety equipment and materials, and I acknowledge that I am solely responsible for the safety and good operating condition of such equipment and material, regardless of where obtained.</p><p>I understand and agree that none of the other participants in these activities, nor any owners of the property where these activities may take place or their agents, including but not limited to Greg Fry, Chris R. Danuser, Rick Hines, Carroll Cave Conservancy, Kansas City Area Grotto, Ozark Highland Grotto and Lake of the Ozarks Grotto, shall be held liable in any way for any occurrence in connection with my activities in or around Carroll Cave or the entrance to Carroll Cave, or for any occurrences arising from or related to those activities, even though such activities or occurrences result in injury, death or other damages to me or my family, heirs or assigns.</p><p>035b5745677992e6301bafdcca196aff.doc In consideration for being allowed to participate in research, exploration and other activities at Carroll Cave and as described in this Release, I hereby personally assume all risks in connection with those activities. I further release the other participants in those activities, all organizations involved in those activities, and the owners of the properties where these activities occur, including but not limited to the persons and organizations identified above, for any injury, death or damage that may befall me while I am a participant in those activities, including all risks connected therewith, whether foreseen or unforeseen, arising out of or relating to my participation in these activities, or that occur while I am on the property where those activities take place or traveling as part of or in support of those activities.</p><p>I state that I am of lawful age and legally competent to sign this affirmation and release; that I understand the terms herein are contractual and not a mere recital; and that I have signed this document of my own free will and act. This agreement supersedes and replaces all earlier agreements pertaining to my involvement in the activities described herein.</p><p>I state that I have had a medical examination to assure myself that I am physically fit as attested to by the medical examination and I assume responsibility for my physical fitness and ability to participate in the activities described herein.</p><p>I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN MYSELF AND THE LANDOWNERS, INDIVIDUALS AND ORGANIZATIONS REFERRED TO HEREIN, AND THE OTHER PARTICIPANTS IN THE RESEARCH, EXPLORATION AND OTHER ACTIVITIES DESCRIBED HEREIN, AND HAVE SIGNED THIS AGREEMENT OF MY OWN FREE WILL AND ACT. </p><p>IN WITNESS WHEREOF, I have executed this affirmation and release at</p><p>______on ______. [place] [date] ______[Your signature]</p><p>______[Witness signature]</p><p>035b5745677992e6301bafdcca196aff.doc</p>