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Membership & Activity Risk Waiver Form

To apply for membership please complete all questions.

The MWCN is a non-profit membership-based organization. Members are informed of our activities, attend for free or receive discounts for events, and are eligible to join our committees and vote at meetings. We offer individual and organization memberships on a 1, 2 and 3-year basis, renewable yearly beginning on April 1 and valid through March 31.

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After you've filled out the form and selected your membership level, you have two options for paying: you can send an e-transfer to mwcn2016@gmail.com (please add note: "membership"),

or you can stop by one of our offices to pay in person.

Membership for Individuals:
$10.00 - 1 year
$20.00 - 2 years
$25.00 - 3 years
N/A
Membership for Organizations:
1 year - $20.00
2 years - $40.00
N/A
Multi-line address
Gender:
Male
Female
Other
Birthday
Year
Month
Day
Would you like to receive our newsletter and all of our information about MWCN events by email?
Yes
No
Would you like to volunteer for our organization?
Yes
No

If YES, please click HERE to fill the volunteer form

Photography and Video Release:
Yes
No

Do you grant the Organization permission to capture and use photographs, videos, or other forms of media that may include my likeness, image, voice, or performance during the activities? If yes, I understand that the Organization may use this media for promotional, marketing, or educational purposes without any compensation to me.

Date
Year
Month
Day
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Membership fees support community events for members and the public, and help run the organization. Members also receive discounts on activities and courses, and a membership card will be mailed upon registration.

This form is provided in accordance with Quebec's Act Respecting the Protection Of Personal Information in the Private Sector (law 25)

Activity Risk Waiver

Name of Organization: Monteregie West Community Network - MWCN, and Partnership Orgnaizations

Activity: All activities organized by or in partnership with MWCN

Location: All MWCN offices or any preferred location designated by MWCN and/or its Partnerships for conducting activities.

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I, the undersigned, hereby acknowledges and agrees to the terms and conditions outlined in this Activity Risk Waiver Form ("Form") in consideration of being allowed to participate in the activities organized by MWCN ("Organization").

 

  1. Assumption of Risk: I understand and acknowledge that by participating in the MWCN activities I voluntarily assume all risks associated with my participation in the activities and agree to release and hold harmless the Organization, its officers, employees, volunteers, and affiliates from any and all claims, demands, actions, or liabilities arising out of or related to such risks.

  2. Health and Medical Condition: I represent and warrant that I am physically and mentally capable of participating in the activities. I acknowledge that it is my responsibility to consult with a medical professional and obtain necessary medical clearance if I have any pre-existing medical conditions or concerns that may affect my ability to safely participate in the activities. I understand that the Organization does not provide medical or health insurance coverage for participants and that any medical expenses incurred during, or as a result of the activities, are my sole responsibility.

  3. Code of Conduct: I agree to abide by all rules, regulations, and instructions provided by the Organization and its representatives during the activities. I understand that failure to comply with these rules may result in immediate removal from the activities without any refund or compensation.

  4. Personal Belongings: I acknowledge that I am solely responsible for the security and safety of my personal belongings during the activities. The Organization shall not be liable for any loss, theft, or damage to my personal belongings.

  5. Governing Law: This Form shall be governed by and construed in accordance with the laws of the province of Quebec. Any disputes arising out of or related to this Form shall be subject to the exclusive jurisdiction of the courts of Quebec.

 

By signing above, I acknowledge that I have carefully read and understood this Activity Risk Waiver Form in its entirety and voluntarily agree to its terms and conditions.

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