Individual Minor Form

INSTRUCTIONS FOR MINOR MEMBERSHIP FORM
This form is for anyone under the age of 18 wishing to participate in NCWC events. The minors legal parent or guardian must fill out the form completely and submit it before the minor can participate in an event. If the legal parent or guardian will not be present with the minor at events then the minor must have a listed sponsor who will be responsible for the minor at events. Any parent and or guardian who will be present with the minor will also need to have a membership with the NCWC. You can go to the Family membership page for this form.
Please fill out the form completely and click submit at the bottom of the page. This will take you to the payment for the yearly dues.

Northwest Civil War Council Minor Membership Form 2017

This form is for all children from birth to 17 years of age. 1 form per child. All red starred boxes are required.

Child's Name *

First

Last

Child's Date of Birth *

Parent/ Guardian Name *

First

Last

Parent/Guardian Name *

First

Last

Parent/Guardian Phone Number *

Parent/Guardian Email *

Parent/Guardian Phone Number *

Parent/Guardian Email *

Child's Address *

Line 1

Line 2

City

State

Zip Code

Country

Sponsor's Name *

First

Last

Sponsor's Phone Number *

Sponsor's Email *

Sponsor's unit *

General Release of Liability-----------------I am fully aware of the nature and purpose of the activities of the Northwest Civil War Council (NCWC). I agree to be bound by the bylaws, rules and policies of the NCWC and to obey the direction of the governing officials at all NCWC events. I acknowledge that reenacting, black powder shooting, and related activities are hazardous, and that I have made a voluntary choice to participate. I agree to assume any and all risks of injury or death that may result from my participation in NCWC events. I agree to release, waive, and discharge from all liability to myself or to any of my family members, and promise not to sue the NCWC, its governing officials, its board of directors, or the owner or lessor of any property on which the NCWC conducts activity, whether caused by those parties, negligence or any other reason, for any injuries which may result form preparing for, practicing for, traveling to or from ,or participating in any NCWC event. I agree to indemnify and hold harmless the parties release above and each of them from any loss, liability, damage or claim they may incur due to my actions during NCWC events, whether caused by their negligence or otherwise. I understand that the NCWC's insurance protects the NCWC, not me. Accordingly, if I injure someone or cause property damage while participating in an NCWC event, the fact that the NCWC has insurance will not prevent the injured party from seeking compensation directly from me. It is my intent that this release be as broad and inclusive as allowed by law, and that if any portion is invalid the remainder shall continue in full force and effect. This release is entered into solely for NCWC events and does not confer a release upon any parties for their actions when not acting in furtherance thereof.--------------------------------------I the parent of the above minor have read, understand and freely agree to the terms of the General Release of Liability-------------Sign in box below *

Emergency Contact Name *

First

Last

Emergency Contact Phone *

Name of Child's Physician *

Physician Phone Number *

Unit Child Wishes to Join *

Military or Civilian *

Combatant Civilian

Date *

PARENT/GUARDIAN AGREEMENT OF MINOR PARTICIPATION--------------------- I am the parent or guardian of the minor(s) listed above. I give my permission for the minor(s) to join and participate in NCWC events. I agree with and hereby sign on behalf of myself and of the minor(s), The General Release of Liability above. I or the sponsor am 18 years of age or older and either I am, or the sponsor is, an active member of the NCWC. The minor(s) belongs in my or the sponsor's unit. I or the sponsor agree to attend every event the minor(s) attends and be responsible for the actions of the minor. ----------------------------------------As the parent or legal guardian of the minor child listed above, I have read, understand and freely agree to all terms and conditions the Minor Participation Agreement-----------------------Sign in box below *

Date *

MEDICAL CONSENT BY PARENT OR LEGAL GUARDIAN OF MINOR CHILD------------------------------- I, being the parent or legal guardian having legal custody of the minor child listed above and below, authorize the performance of all medical, surgical, diagnostic and hospital care, procedures or treatment, which may be performed or prescribed for the minor child by a licensed physician or hospital, when reasonable efforts to timely contact me are unsuccessful and when such care or procedures are deemed immediately necessary or advisable by the physician to safeguard the minor child's health.-----------------------------------------I hereby waive my right of informed consent to such care, procedures or treatment for the child listed above.------------------Sign in box below *

Date *

Comments *

Submit

​Northwest Civil War Council Minor Membership Form 2017

Northwest Civil War Council Minor Membership Form 2017