WAIVER AND RELEASE
In signing this form for myself and/or as the adult responsible for a child under age 18, I agree to hold harmless, absolve, waive, release, and discharge (CLUB NAME), and all of its officers, directors, members, incorporators, owners, organizers, volunteers, vendors, suppliers, insurers, and sponsors (collectively "CLUB NAME"), of and from all blame, liability, suits, claims, demands and/or causes of action for any injury, death, misadventure, harm, loss, inconvenience or damage of any kind suffered or incurred as a result of any activity associated with (CLUB NAME). I represent that I am in good physical and mental condition, and that I have sufficient skills and experience to safely complete any bicycle ride, race, tour or event in which I choose to participate. I realize there is a possibility that physical injury, death and/or property damage to me or others can occur as a result of bicycling. Knowing the risks, I agree to assume the risks, and I further agree to release, hold harmless and indemnify (CLUB NAME) from all liability, suits, demands, claims, and/or causes of action asserted by either myself or any other person as a result of my attendance at, or participation in, any activity associated with (CLUB NAME). I agree to wear an approved bicycle helmet on all (CLUB NAME) rides, races, tours and events. I further agree to ride safely and responsibly with due regard for my safety, the safety of others and the environment. (CLUB NAME) does not endorse the building or riding of 'stunts' without the express permission of the land owner.
Signature _______________________________________ Date ______________________ Signature _______________________________________ Date ______________________
[For a family membership, each member of the family must sign.] Signature of Parent or Guardian, if applicant is under the age of 18 ___________________________________________
Printed Name of Parent or Guardian:___________________________________________
