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By sending this form and signing with your initials, the participant acknowledges the following: 1) Agree to follow the by-laws of the BCKFC 2) Acknowledges and fully understands that he or she will be engaging in activities that involve risk of serious injury, including permanent disability and death, not only from his/her own actions, inactions, and negligence of others and the condition of the equipment used. Furthermore, there may be risks known to us or not reasonably foreseeable at the time. Assumes the foregoing risks and accepts personal responsibility for the damages following such as injury, damage to personal property, permanent disability, or death. The undersigned has read the above waiver and release, understands that he/she has given up substantial rights by sending this form and does so voluntarily. Annual Dues are $25 per year for individual membership and $40 per year for family membership. BCKFC Treasurer Wesley Miller • 1624 Chevelle Dr. • Baton Rouge, LA 70806 Have a comment or question? Call Wesley at (225)205-7230 Note: Click Submit and if all required fields are complete a payment page will appear. • Online payment via Paypal. • Cash or Check sent to Wesley Miller. Check this box if paying with Paypal.

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