VIP Card Renewal Form Test 2024 Seasonal Courtesy Card Test First Name*Last Name*VIP Card Number*Date of Birth*Format: 01/01/1980This field is hidden when viewing the formDOBMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Phone*Email* Address*City*State*ZIP Code*Terms and Conditions* I agree to the terms as stated belowI agree the Parker House V.I.P. Card that I am purchasing or renewing from the previous year is the sole property of the Parker House in Sea Girt, NJ. I agree that this Parker House V.I.P. Card must be renewed every year before Memorial Day. I understand that this Parker House V.I.P. Card can only be purchased or renewed under the name that it is currently registered under. I agree that this Parker House V.I.P. Card is nontransferable and can only be used by its registered owner. I agree that the Parker House V.I.P. Card that I have purchased or renewed can be revoked at any time at the Parker House’s sole discretion for any violation or conduct deemed inappropriate. These violations and conduct include, but are not limited to, any infractions of the Sea Girt municipal code, any destructive behavior or aggression toward Parker House property or staff, and any inappropriate actions or behavior toward Parker House clientele or neighbors.Waiver and Release / Promise Not to Sue* I have read and agree to the terms of the Waiver and Release / Promise Not to Sue.Avon Hotel Corporation d/b/a Parker House and Columns WAIVER AND RELEASE / (PROMISE NOT TO SUE) As a new or re-newing Parker House VIP Cardholder, I acknowledge that I am familiar with the circa 1878 Parker House Premises and its seasonal business operations; and I understand and agree that listening to music, singing, dancing, mingling, moving about, and consuming alcohol amongst a large group of patrons in a lively and fun, classic seashore environment like that offered on Parker House Premises provides meaningful benefits to me, and may also create conditions that involve inherent risks of injury to me. Such conditions may include: (1) patrons may spill drinks and cause floors, stairs, or other surfaces to become wet; (2) glass or drink condiments may be dropped; (3) lighting may be dim to preserve ambiance; (4) music and patrons may be loud or distracting; (5) patrons may bump into me or impede my movement; (6) Parker House staff may direct my movement or escort me off Premises; (7) rain, condensation, or other natural elements may cause Parker House Premises to become wet; (8) access to and from Parker House Premises involves slopes, gravel, and stairs, which may be physically challenging to me. I UNDERSTAND THAT THESE AND OTHER CONDITIONS MAY OCCUR AT ANY TIME ON PARKER HOUSE PREMISES AND MAY CAUSE ME TO SUSTAIN INJURY. I agree that this Waiver and Release is sufficient notice and warning to me of conditions that involve inherent risk of injury. I understand these conditions may be unpredictable and may occur spontaneously at any time, that the presence of other patrons may limit my ability to see or avoid such conditions, and that my presence on Parker House Premises may cause or contribute to such conditions. I understand that Parker House Premises includes the entire Parker House building, its porches and stairs, driveway, sidewalks, grass and real property surrounding the building, and sections of the surrounding streets. I acknowledge that I have considered and weighed the benefits and risks of entering Parker House Premises, and I agree that every time I enter Parker House Premises during the 2025 season, I do so voluntarily and entirely at my own risk. I acknowledge that I have carefully read this Waiver and Release and fully understand that it is a release of liability and a promise not to sue, and cannot be modified orally. In consideration for my receipt of a Parker House VIP Card for the 2025 season, I voluntarily agree to accept the terms of this Waiver and Release, and to accept all risk of injury from the conditions listed above and other reasonably foreseeable conditions that may occur on Parker House Premises; and I, on behalf of myself, my next of kin, heirs and representatives, AGREE TO RELEASE FROM ALL LIABILITY AND PROMISE NOT TO SUE Avon Hotel Corporation and its employees, officers, directors, owners and agents for any claim for any physical or psychological injury, illness, damages, or economic or emotional loss I may sustain as a result of such conditions, or from my presence on Parker House Premises. I understand and agree that this Waiver and Release will cover the entire 2025 season and will be applicable every time I enter Parker House Premises during the 2025 season. I understand and agree that the term of this Waiver and Release will extend beyond the 2025 season and remain in full force and effect for as long as the statute of limitations for any claim for any injury I may sustain remains open. I understand that my Parker House VIP Card is also valid for admission to Columns in Avon, NJ, and I acknowledge that I am familiar with the Columns circa 1883 Premises and its seasonal business operations, which are substantially similar to Parker House operations. I understand and agree that my presence on Columns Premises also provides meaningful benefits to me and may create conditions that involve inherent risks of injury to me. In consideration for my admission to Columns, I agree that every time I enter Columns Premises during the 2025 season, I do so voluntarily and my own risk; and I voluntarily agree that the terms of this Waiver and Release, including the promise not to sue, will apply every time I enter Columns Premises as if the words Parker House were replaced with the word Columns. This Waiver and Release is governed by the laws of the State of New Jersey. If any portion of this Waiver and Release is deemed by a Court of competent jurisdiction to be invalid, then the offending words will be severed and the remainder of this Waiver and Release shall remain in full force and effect.
