MEMBERSHIP APPLICATION

                                                                 Englewood Fishing Club - Application/Renewal

                                                                    (Check One)___ New Membership___ Renewal

     Englewood Fishing Club (hereinafter referred to as the “EFC”) is on a calendar

 year basis, running from January 01 to December 31 of each year. Dues are $50.00

per year for both single and family membership.  Full dues are required for

 memberships received through September; after October 1 membership will be

 valid for the remainder of the year and all of the following year.

      IN CONSIDERATION of being permitted to participate in EFC sponsored activities, I, for myself,  my personal representatives, assigns, heirs, and next of kin: (1)  ACKNOWLEDGE, agree and represent that I understand the nature of fishing and boating activities and that I am qualified, in good health and in proper physical condition to participate in club activities. I warrant that at any time I believe conditions  to be unsafe, I will discontinue further participation in the EFC: (2)  UNDERSTAND that; (a) fishing  boating activities involve risk and dangers of serious bodily injury, including permanent disability, paralysis and death; (b) these risks and dangers may be caused by my own actions or inactions, the actions of others participating in the activity, the condition which the activity takes place, or the negligence of the “Releases” named below; (c) there may be other risk and social and economic losses either not known to me or not readily foreseeable at this time; hence I fully accept and assume all such risk and all responsibilities for losses, cost and damages I incur as a result of my participation  in the EFC activities: (3)  HEREBY release, discharge and covenant not to sue the EFC, the respective administrators, directors, agents, officers, volunteers, and employees, other participants, sponsors, advertisers, owners and lessors of premises on which the activities take place (each considered one of the “Releases” herein) from all liability, claims, demands, losses, or damages on my account caused in whole or in part by the negligence of the “Releases” to include negligent rescue operations. I further agree that if, despite this Release and   Waiver of Liability, assumption or risk, and indemnity agreement, I, or anyone on my behalf, makes a claim any of the “Releases”, I will indemnity, save, and hold harmless each of the “Releases” from any litigation expenses, attorney fees, loss of liability, damage, or cost which may occur as a result of such claim.

     I HAVE READ THIS AGREEMENT, fully understand the terms, understand that I have given up substantial rights by signing it, and have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid, the balance shall continue in full force and effect.

                                                                                                  PLEASE PRINT

NAME___________________________________________________

NAME___________________________________________________

PHONE______________________________EMAIL_________________________________________________

LOCAL ADDRESS__________________________________________________

CITY/STATE/ZIP___________________________________________________

OTHER ADDRESS _________________________________________________

CITY/STATE?ZIP __________________________________________________

SIGNATURE_______________________________________________

SIGNATURE______________________________________________             DATE: ________________________

                                Mail to: Casper Labarbera 23 Savona Ave. Englewood, Florida 34223