[gview file="https://vdoe-nh.org/wp-content/uploads/2018/03/2018-canoe-rack-registration-form-Final.pdf"]
Board of Commissioners
Village District of Eidelweiss
1680 Conway Rd Box 1027
Madison, New Hampshire 03849
603-367-9022
2018 CANOE RACK REGISTRATION
Registration period for 2018 is March 26, 2018 through June 1, 2018. Registration cost is $25.00. Make check payable to VDOE. Checks must be received with registration form in order to be considered. Registration forms will be dated upon receipt and opened in order of receipt for rack space assignment. Returned checks will be charged a $35 check fee and denial/revocation of rack space until registration fee and charges are paid.
Name ______________________________________
Mailing address_________________________________________________________
Phone________________ Email address________________________________
Eidelweiss street address__________________________________________________
Description of watercraft – include color and any identifying markings__________________________
________________________________________________________________________________
First choice Beach Boulder, Eidelweiss, Thusis, Geneva, Porridge Shore (circle one)
Second choice Boulder, Eidelweiss, Thusis, Geneva, Porridge Shore (circle one)
Third choice Boulder, Eidelweiss, Thusis, Geneva, Porridge Shore (circle one)
Fourth choice Boulder, Eidelweiss, Thusis, Geneva, Porridge Shore (circle one)
By submitting this registration form, I acknowledge and agree that VDOE, though providing registration for this space for my watercraft to be stored on District property, does not accept any liability for the safety or condition of my watercraft, and that I use the canoe rack at my own risk. I acknowledge and agree that VDOE is not liable for any damage, injury, or loss that may occur in connection with my use of the canoe rack, the beach, or my watercraft. I agree to indemnify and hold harmless VDOE and its agents from any claim for damage, injury or loss that may arise in connection with my use of the canoe rack, the beach, or my watercraft
Signature of owner:
_________________________________________________