storage waiver - Clover Sites

STORAGE WAIVER I understand that I am storing my boat/watercraft/golf cart and accessories/contents in the tabernacle for the winter season solely at my own risk. I will ensure I have sufficient insurance coverage as applicable to my unit. I hereby release Ottawa Valley Pentecostal Camp and the Pentecostal Assembles of Canada and all of its officers, directors, ministers or staff from any and all claims regarding any loss or damage to my property including fire, theft, vandalism, animal or rodent damage, natural disasters or any other damage regardless of the cause. Name: _______________________________ Phone Number: _________________________ Full Address: _________________________________________________________________ E-mail Address: _______________________________________________________________ Insurance Company: ___________________________________________________________ Insurance Policy Number: _______________________________________________________ Signed: ______________________________ Date: ___________________________________ Watercraft length is to be determined by stern to bow measurement (not including motor or stern drive). Trailer length is not applicable. Boat Fee (Length ______ feet X $9.00/foot) Personal Watercraft (_____ X $50.00) Personal Watercraft (2 on same trailer=$75.00) Golf Cart (_____ X $25.00) SUBTOTAL Add 13% HST TOTAL

$ _____________ $ _____________ $ _____________ $ _____________ $ _____________ $ _____________ $ _____________

Please make cheque payable to O.V.P.C. or contact the office for Debit/Credit Card payments. All payments must be received at the CAMP OFFICE prior to your vehicle being placed into storage. NO EXCEPTIONS PLEASE.

Revision 02 Ottawa Valley Pentecostal Camp 876 Faught Road Cobden, ON K0J 1K0

October 2012 Phone: 613-638-2000 Fax: 613-638-5000 E-mail: [email protected]