Phoenix Metro Bicycle Club
THIS IS AN IMPORTANT DOCUMENT THAT WAIVES YOUR LEGAL RIGHTS.
NAME OF EVENT: White Mountain Tour Date: July 12 & 13, 2008
RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, INDEMNITY AGREEMENT, AND WAIVER OF CONSTITUTIONAL RIGHT
In consideration of my participation in any way in the Phoenix Metro Bicycle Club ("Club") sponsoring bicycle activities ("Activity"), I do for me, my personal representatives, assigns, heirs and next-of-kin:
I EXPRESSLY ACKNOWLEDGE WAIVING THE AFOREMENTIONED CONSTITUTIONAL RIGHT. Initial Here: _______
I have read this Agreement, fully understand its terms, understand that I am giving up substantial rights including waiving a constitutional right, by signing it, and have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release and/or waiver of any and all liability and/or constitutional right to the greatest extent allowed by the law and agree that if any portion of this agreement is held to be invalid, the balance notwithstanding shall continue in full force and effect.
PRINTED NAME OF PARTICIPANT: ____________________________________________
PHONE:____________________________
ADDRESS: __________________________________________
City: _______________________ State: _________ ZIP: ______________
PARTICIPANT'S SIGNATURE _________________________________________________________
DATE:__________________________
Emergency contact information:
Name ________________________________________________ Phone: _________________________
MINOR RELEASE : AND I, THE MINOR'S PARENT AND/OR LEGAL GUARDIAN, UNDERSTAND THE NATURE OF BICYCLING ACTIVITIES AND THE MINOR'S EXPERIENCE AND CAPABILITIES AND BELIEVE THE MINOR TO BE QUALIFIED, IN GOOD HEALTH, AND IN PROPER PHYSICAL CONDITION TO PARTICIPATE IN SUCH ACTIVITY. I HEREBY RELEASE, DISCHARGE, COVENANT NOT TO SUE, AND AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS EACH OF THE RELEASEE'S FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON THE MINOR'S ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE "RELEASEES" OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS AND FURTHER AGREE THAT IF, DESPITE THIS RELEASE, I, THE MINOR, OR ANYONE ON THE MINOR'S BEHALF MAKES A CLAIM AGAINST ANY OF THE RELEASEES NAMED ABOVE, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES FROM ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS LIABILITY, DAMAGE, OR ANY COST WHICH MAY INCUR AS THE RESULT OF ANY SUCH CLAIM.
PRINTED NAME OF PARENT/GUARDIAN: ______________________________________________
PHONE:_______________________
ADDRESS: ___________________________________________
City: _______________________ State: _________ ZIP: ____________
PARENT/GUARDIAN SIGNATURE: __________________________________________________________________
DATE: __________________________
(Only if participant is under the age of 18)