CERALAND

How would you like to receive your membership cards? *
Mail them to my home address.
I will pick them up at the Sports & Fitness Center upon my next visit.

ELIGIBLE FAMILY MEMBERS

An eligible family member may include a spouse (or recognized domestic partner, if approved by your company), and children 20 years old and under (not married) living in the same house as their parents. Children 21 years old and over with student status and a current student ID (not married) living at home may also be included. All other individuals not listed above are considered guests and must be accompanied by a CERA member.

Agreement

By submitting this application, I hereby confirm that the above information is true and correct. I further understand that if the above information is determined to have been falsely stated, I will forfeit my CERA privileges.

Disagree Agree

Furthermore, I understand that all members must present their membership cards upon entrance to the Park, the Sports & Fitness Center, and all outdoor facilities. Children 3 years of age and under are admitted without I.D. cards when accompanied by adult members.

Furthermore, I agree to uphold all the CERA Rules and Regulations will enforce them with any of my guests and / or dependants. I understand that any persons displaying objectionable behavior and / or violating the rules may be removed from the park by CERA Management and may result in the termination of my park privileges.

Disagree Agree

Furthermore, I, the participant, parent or legal guardian, hereby agree to waive, release and indemnify Cummins Employees Recreation Association, Inc., it’s Board of Directors, Officers, Agents and Assigns from any and all claims, demands, actions or suits (including, but not limited to costs and attorney’s fees), arising out of any injury, death, damage or loss which might be sustained by me, my dependants or any persons as a result of my participation in this membership program.

Disagree Agree

Furthermore, I, the participant, hereby agree to a minimum of one year (12 months) membership or until the end of the membership year. I may elect to discontinue my membership after that time has elapsed. Should the account be referred for collection, the applicant shall pay reasonable attorney's fees and costs of collection.

Furthermore, I acknowledge that I have read and understand the above agreement.

Applicant's Name *

(By filling in your name, you are acknowledging the same as a written signature of acceptance)

Date Submitted