Barbara Schomer Preserve Trip Participant Application

Permit Application for those requesting to visit Sarah Furnace Cave on a trip organized by someone else.

Name *

First

Last

Address *

City, State, Zip *

Contact Person's Email *

Cell Phone Number *

Club Affiliation

NSS Member *

• Yes
• No

NSS Number

MAKC Member *

• Yes
• No

MAKC Number

Name of Person Organizing Trip and Purpose of Trip

Proposed Trip Date *

Estimated Time of Arrival *

Call Out Time *

Emergency Contact Name *

First

Last

Contact Person's Phone *

Contact Person's Email *

Emergency Contact Other Information

Have you been to the Barbara Schomer Preserve before? *

• Yes
• No

Equipment *

• Helmet
• Primary light
• Secondary light
• Tertiary light
• Gloves
• Lug-soled boots
• Coveralls

Are you driving and if so what type of car will you have?

Any fees involved with this trip? *

• Yes
• No

Have you read and understood the access guidelines, management plan, and agreed to comply? *

• Yes
• No

This is a Legal Agreement—Read Before Signing. I would like to organize a caving trip to Sarah Furnace Cave on the Barbara Schomer Preserve of the MAKC. Other trip participants will accompany me, no more than ten. *

• Yes
• No

Risk of Harm. I acknowledge that caving is inherently dangerous. I understand that among the risks of harm from caving and the trip is injury, disease or even death that can result from (for example) rockfall or ceiling collapse (whether in natural cave passages or in mined areas of a cave, slips, falls, uneven floors or pits, lack of light, becoming lost or stuck or trapped, drowning, hypothermia, bad air, contact with wild animals (for example, bears and bats), equipment failure and failures to rescue, and from my or others' actions or inactions. *

• Yes
• No

Assumption of Risk. I assume all risk of any harm (including injury, disease, or even death) that I may suffer in connection with the trip. *

• Yes
• No

Liability Release and Waiver. I forever release and waive all legal claims against each caver in connection with the trip, even if the caver was negligent. *

• Yes
• No

Promise Not to Sue. I promise not to sue a caver and the MAKC in connection with anything that happens during this trip. *

• Yes
• No

Indemnity and Defense. I promise to indemnify, defend, and hold harmless any caver and the MAKC for liability or expense related to any harm (including injury, disease, or even death) that I may suffer in connection with the trip. *

• Yes
• No

Duration, Successors, Choice of Law, Forum. This agreement does not expire. It applies to my successors, heirs and assigns and benefits, MAKC, cavers' successors, heirs and assigns. Pennsylvania law governs (except its choice of law rules). Pennsylvania courts have exclusive jurisdiction in any dispute relating to the trip or this agreement. *

• Yes
• No

I have carefully read this agreement. I am voluntarily agreeing to it, and I intend to be legally bound. *

• Yes
• No

Typing my name below constitutes my legal and binding signature. *

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