Quarry Lake Membership Application, Instructions and Checklist

Pre-Checklist:

1. Print, complete, and sign Quarry Lake Membership application form below. Make out check to “SPLWSA”

2. Become a member of both the Shakopee - Prior Lake Shockwaves, and USA Waterski, if you are not already a member. (Applications are available on-line at www.splwsa.org and www.usawaterski.org.

3. Read, print and sign a copy of the Quarry Lake Waiver below.

4. Send application, check, and Waiver to SPLWSA address below.

5. Send certificate of boat insurance for the AWSA approved boat you will use at Quarry Lake. Boat insurance liability limit minimum is $500,000, and USA Waterski and SPLWSA must be listed as additional insureds on that policy. When you make a request to your insurance company to list additional insureds, they will ask you for addresses for each of the two additional insureds. The addresses are:

SPLWSA
P.O. Box 867
Prior Lake, MN 55372

USA Waterski
1251 Holy Cow Rd.
Polk City, FL 33868

Generally, your insurance company will send a certificate of insurance to the above addresses once you give them the addresses.

If you have questions, please contact us at quarrylake1@yahoo.com

2009 Quarry Lake New Membership Application
You must also be an active member of both SPLWSA and USA Waterski in order to be a Quarry Lake Member. If you are already a USA Waterski member, please enter your member number in the appropriate field below. If you are not a member of SPLWSA and USA Waterski, you may apply separately on-line at www.splwsa.org and www.usawaterski.org

First Name: __________________ Middle Initial: ___   Last Name________________
Date of Birth: ___ /____ /______     USA Waterski Member #: __________________
Address:       ___________________________
                       ___________________________
Day phone: (_____) _____ - ________      Evening phone: (_____) _____ - ________
Mobile phone: (_____) _____ - ________
E-mail address: _____________________________
Make, Model, Year of AWSA approved boat(s) you will use during your time-slot________________________________
MN License number of AWSA approved boat(s) you will use during your slot: ____________
Boat insurance company (not agent): _____________________
Policy number: ______________________
Quarry Lake Membership Time-slots
1.         Day__________          Time__________         Fee__________
            2.         Day__________          Time__________         Fee__________
            3.         Day__________          Time__________         Fee__________

Quarry Lake Boat Storage Fee
___ I plan to store my boat at Quarry Lake during the 2009 season. Please understand that neither SPLWSA nor the City of Shakopee can take responsibility for the security of your boat. Store your boat at Quarry Lake at your own risk.
____ $250 per boat for storage on my own boat lift in designated areas of Quarry Lake water
____ $100 per boat for storage on my trailer in designated parking area at Quarry Lake

Total amount of check enclosed: $______________ (Check made out to SPLWSA). Please include full amount for 2009 time-slots plus the storage fee amount, if any. Return completed and signed application along with your check to: SPLWSA Quarry Lake, P.O. Box 867, Prior Lake, MN 55372

Please submit a check for the entire amount of the time-slots you are RENEWING, plus boat storage fee if applicable . (You do not need to send money at this time for trade-up and additional time-slots. If additional slots you’ve requested become available, we will contact you. If you wish to make changes at that time, and those changes cause you to deserve a refund or obligate you for additional payment, we will issue a refund or ask for an additional check depending on what you decide to do). No partial payments will be accepted. Thank you! Please send us a note via e-mail if you have questions. quarrylake1@yahoo.com

Other SPLWSA Members in my Quarry Lake Ski Group
Please list the names of the others who will generally ski with you at Quarry Lake during your time-slot(s). Thank you. This list will help us understand who is using Quarry Lake when. As in past years, you may invite any SPLWSA active Member to ski with you during your time slot.
_______________ ______________ _______________ _______________ _______________ _______________

Release, Waiver and Agreement
Quarry Lake Membership enables me defined privileges to participate in certain Prior Lake Waterski Association (aka PLWSA, dba Shakopee-Prior Lake Waterski Association, dba Shockwaves), activities at Quarry Lake or to visit Quarry Lake to watch PLWSA activities. I acknowledge that the Quarry Lake property is owned by the City of Shakopee (City) and made available to and used by the PLWSA under a Use Agreement between the City and PLWSA which defines PLWSA Member rights and obligations at Quarry Lake. I understand that access to the Quarry Lake site is via private roadways owned by Aggregate Industries, Inc. and on land leased to Aggregate’s subcontractor, Bituminous Roadways, Inc.

In return for these Quarry Lake access and use privileges, I hereby for myself, my heirs, executors and administrators, release and forever discharge the City of Shakopee (City), Aggregate Industries, Inc. , (Aggregate), Bituminous Roadways, Inc., (BR), and PLWSA, their directors, members, employees, agents, servants, and all other persons connected with the City, Aggregate, BR, and PLWSA, of and from any and all rights, claims, demands, and actions whatsoever that I may have for any and all loss, damage, or injury sustained by me, my family, or my personal property in connection with attending or participating in activities at Quarry Lake.

I certify that I have received and read a copy of both the rules for use of Quarry Lake, including the Quarry Lake Boats/Engines Policy, and the Environmental Report concerning Quarry Lake. I have received a copy of the SPLWSA Directions to Quarry Lake, promise to enter and exit the site only by the route specified therein, and to see that others who ski during my time-slot do the same. I agree to be responsible to see that those that ski with me at Quarry Lake are active SPLWSA Members. I understand and agree to take responsibility for the risks, rules and obligations of using Quarry Lake, and I agree to take responsibility that those in my Quarry Lake skiing party will do so as well. I understand that my time-slots may be pre-empted up to three times per year for tournaments, clinics, and other events at Quarry Lake. In addition, I agree to perform at least five hours volunteer labor at or for Quarry Lake prior to or during the 2009 ski season, and to see that those who will ski with me this year will do the same.

Applicant’s Name (print): _____________________ Signature: ________________________
D.O.B. __________

Questions or Comments? Contact: waterskier@priorlakewaterski.org