Nature Coast Anglers
 A Salt Water Fishing Club based out of Citrus County, Florida  

Membership Application

APPLICATION 

NATURE COAST ANGLERS FISHING CLUB 


In completing this application, the undersigned applicant indicates he/she is an enthusiastic angler and is willing to participate in the club's activities, by voice and by presence.

Prior to joining, applicants should check out the NCA website for club and tournament rules and tournament schedules. WWW.NATURECOASTANGLERS.COM
If paying by check, make payable to CASH or STEVE OGIER (NCA treasurer).

PLEASE PRINT

Name:___________________________________________

Phone:_____________________

Mailing Address: ___________________________________ 
City:_______________________Zip:_____________

Spouse's Name: ______________________________

E-Mail  Address_______________________________

How did you hear about our club? ____________________________________

Do you have a boat? Yes ( ) No ( ) Make/Length _________________________

Do you have a VHF radio? Yes ( ) No ( ) VHF Call name : __________________

Are you willing to serve an appointment to a committee? Yes ( ) No ( )

Do you have a valid Florida fishing license? Yes ( ) No ( )

Are you  21 years of age or older.  Yes ( ) No ( )

Annual dues (currently $25.00 ) paid will be refunded if the Executive Committee does not accept membership, or if membership is rejected by applicant upon reading the Club By-Laws and Policies and Procedures.

Please complete Liability and Waiver form below.

Date Approved:___________________________

 LIABILITY ACKNOWLEDGEMENT AND WAIVER OF CLAIMS

IN CONNECTION WITH ACTIVITIES OF NATURE COAST ANGLERS 

I,________________________________________ am a member and participate in the group/club known as Nature Coast Anglers, which engages in sport fishing and other recreational outings. For, and in consideration of, the reciprocal release of other members of Nature Coast Anglers to me and for One Dollar ($l.00) paid to me by Nature Coast Anglers and for other good and valuable consideration to me, including my right to participate in the activities of Nature Coast Anglers, I, the undersigned, for and on behalf of myself and my heirs, successors, and assigns, assume sole and exclusive liability and release Nature Coast Anglers and its members and participants ("Released Parties") from liability for any damage to my person or property that I may incur as a result of or in the course of any activities of Nature Coast Anglers.

It is specifically understood and agreed that this Liability Acknowledgment and Waiver Of Claims includes, but is not limited to, any and all claims, which I may have against the Released Parties, or any of them, whether such claims are based upon tort, contract, common law, and/or statutory law.

I agree not to institute or assist others in instituting any action against Released Parties for or because of any incident or event occurring prior to the date of this Liability Acknowledgment and Waiver Of Claims.

I declare that I have fully read the foregoing Liability Acknowledgment and Waiver Of Claims in its entirety and that I have been fully advised by my attorney or have had an opportunity to receive advice from an attorney, prior to executing this Liability Acknowledgment and Waiver Of Claims, and that I know and understand the contents hereof and have signed the same as my own free, intelligent, and voluntary act.

Signature:_____________________________________________________________

Print Name:____________________________________________________________

Witnessed by: __________________________________________________________



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