New Member Application Form

Strengthening Families Initiative

New Member Application Form

Contact Details

First name: Surname: Email Address: Mobile Number:

Membership Type:

Select your Membership Type:

Membership Information:

Comments

Roster Preferences:

As we are a member-run organisation, you will be required to assist in the toy library 3-4 times a year. Please select your preferred roster day:

First Roster Pref:

Second Roster Pref:

Agree and Submit:

I agree to the Terms and Conditions of membership set out by the Strengthening Families Initiative

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WAIVER, RELEASE AND INDEMNITY FOR BICYCLES AND SCOOTERS

ACKNOWLEDGEMENT - SAFETY

I acknowledge that I have been advised to wear an approved helmet while cycling. I am aware that the use of the tricycle/scooter is subject to any applicable municipal and provincial highway traffic regulations. I am familiar with the proper use of the tricycle/scooter, including all quick release mechanisms, brakes and gear shifters.

ASSUMPTION OF RISKS

I am aware that cycling activities involve many risks, dangers and hazards including, but not limited to: changing weather conditions; mechanical failure of the equipment; loss of balance; difficulty or inability to control one’s speed and direction; variation or steepness in terrain; rapid or uncontrolled acceleration on hills and inclines; variation or changes in the cycling surface including holes or depressions in the roads; exposed rock, snow, ice, earth and other natural objects; streams, creeks and rivers; cliffs and crevasses; collision with exposed rock, snow, ice, earth, trees or other natural or man-made objects on or adjacent to the cycling terrain; encounters with wildlife, collision with pedestrians, vehicles or other cyclists; becoming lost or separated from the guides or instructors or other participants; failure to cycle safely or within one's own ability or within designated areas; negligence of other participants; and NEGLIGENCE ON THE PART OF Bikes to Borrow OR THEIR STAFF INCLUDING THE FAILURE ON THE PART OF Bikes to Borrow OR THEIR STAFF TO SAFEGUARD OR PROTECT ME FROM THE RISKS, DANGERS AND HAZARDS OF ADVENTURE ACTIVITIES. I am also aware that the risks, dangers and hazards referred to above exist throughout the area used for cycling and that many are unmarked.

I will not attempt repairs or removal of bike parts held by screws or nuts. Saddles and pedals are exempt. I acknowledge that United Way of Delaware County is exempt from any and all accidents resulting from the use of toys.

I AM AWARE OF THE RISKS, DANGERS AND HAZARDS ASSOCIATED WITH CYCLING ACTIVITIES AND I FREELY ACCEPT AND FULLY ASSUME ALL SUCH RISKS, DANGERS AND HAZARDS AND THE POSSIBILITY OF PERSONAL INJURY, DEATH, PROPERTY DAMAGE AND LOSS RESULTING THEREFROM.

I Agree

Terms & Conditions of Application

As a member you agree to the following:

I/we agree to return the toys in the condition that they were borrowed in.

I/we agree to return the toys with the same number of pieces they were checked out with. Number of pieces can be located on the label.

I/we agree to return the toys on or before their 21 day due date.

I/we agree to provide a form of identification as a Delaware County resident on your first visit.

United Way of Delaware County reserve the right to apply fees and/or revoke membership for any abuse of this agreement.

I/we agree to assume the risk associated with using and/or borrowing toys from the Strengthening Families Toy Library.

I/we agree to provide appropriate adult supervision and to follow toy guidelines for safe use, minimum age and choking hazards.

I/we agree to hold harmless the United Way of Delaware County, its employees and volunteers from any and all claims that may result from accident, injury or death, accidental or otherwise, arising from use of Toy Library toys and materials.

United Way of Delaware County reserve the right to apply fees and/or revoke membership for any abuse of this agreement.

I Agree

Code of Conduct of Application

I Agree