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Membership Application/Renewal Form

Regular Member $15.00 per calendar year

Silver Member $100.00 per calendar year

Platinum Member $250.00 per calendar year

Fulltime Student Member FREE per calendar year

Regular and Silver member please Complete Section I & II.

Platinum Member please complete All Sections

Section I

(Complete Sections I & II.Must be Malaysian citizen or descendant of a
former Malaysian citizen. Please provide copy of current Student I.D. Card)

Heading 6

Patinum Sponsor

Silver Sponsor

None

Section II

To determine voting rights, please answer the following questions

Are you OR your spouse OR one of your parents a citizen or former resident of Malaysia ?

YES

NIL

If YES,

You

Spouse

parents

NIL

Section III

For Platinum use only. You may sponsor one FREE
membership per paid calendar year

Is your sponsored member a
citizen or former resident of Malaysia ?

YES

Don't Know

For New Member Only

Waiver Form -Release and Covenant Not To Sue

I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES ASSOCIATED WITH THIS EVENT, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault.  I certify that I am physically fit, have sufficiently prepared or trained for participation in this activity, and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my participation in this activity.  I acknowledge that this Accident Waiver and Release of Liability Form will be used by the event holders, sponsors, and organizers of the activity in which I may participate, and that it will govern my actions and responsibilities at said activity.  In consideration of my application and permitting me to participate in this activity, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:  (A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this activity, THE FOLLOWING ENTITIES OR PERSONS: The Soil Ecology Society, (SES) and/or their directors, officers, employees, volunteers, representatives, and agents, and the activity holders, sponsors, and volunteers;  (B) INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this activity, whether caused by the negligence of release or otherwise.  I acknowledge that SES and their directors, officers, volunteers, representatives, and agents are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific activity on their behalf.  I acknowledge that this activity may involve a test of a person's physical and mental limits and carries with it the potential for death, serious injury, and property loss. The risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, lack of hydration, and actions of other people including, but not limited to, participants, volunteers, monitors, and/or producers of the activity. These risks are not only inherent to participants, but are also present for volunteers.  I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this activity.  I understand while participating in this activity, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the activity holders, producers, sponsors, organizers, and assigns.  The Accident Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.  I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL.

I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF

LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL.

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Malaysian Association of Southern California

Membership Application/Renewal Form

Section I

Heading 6

Section II

Are you OR your spouse OR one of your parents a citizen or former resident of Malaysia ?

If YES,

Section III

For New Member Only

Waiver Form -Release and Covenant Not To Sue

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