Bike For Change
RELEASE AND WAIVER OF LIABILITY
For consideration of participation in the Bike for Change event to be held on June 11, 2016, I, ______________________________, waive and release Forget Me Not Advocacy Group Inc., its chapters, directors, officers, administrators, representatives and executors, past and present employees, volunteers, agents, supervisors, participants, all city and state governments, assigns, all sponsors, their representatives and successors and other persons (collectively, the “Releasees”), from any and all claims, liabilities, or causes of action arising out of an injury to me (or my child) and from any and all claims, liabilities, or cause of actions arising from my (or my child’s) participation or attendance in this event.
Inherent and Potential Risks
I understand that the Bike for Change involves strenuous physical activity associated with bicycling long distances. I understand that physical activity, by its very nature, carries with it certain inherent risks. I assume all risks associated with participating in the Bike for Change relating to the risk of strenuous physical activity, collisions with other riders, or falling off of my bicycle. I acknowledge that I (or my child) may incur minor injuries, major injuries, and catastrophic injuries including paralysis and death. I assume all risks from contact with other participants and volunteers, negligent or wanton acts of other participants and volunteers, any defects of conditions of road surfaces (including uneven or wet road surfaces or gravel on the road surface), failure of cyclists, vehicles, and non-participants to observe traffic signals or laws, and the effects of weather including high heat, thunderstorms, lightning, precipitation, cold temperatures, high winds, and/or humidity.
I acknowledge that my participation in the Bike for Change may involve time off of my bicycle where I am still attending the Bike for Change event. I assume all risk for any and all activities in addition to cycling that I (or my child) engage in throughout the entirety of the Bike for Change event, including my (or my child’s) safety from the beginning of Bike for Change to the conclusion of the event.
I agree to dress myself (or my child) appropriately as to mitigate risk of physical injury to myself (or my child) including, but not limited to: wearing shoes appropriate for strenuous cycling involved in the Bike for Change; and dressing in conjunction with the weather. I understand that wearing a helmet that satisfies Consumer Product Safety Commission (“CPSC”) standards is a requirement to participate in the Bike for Change. I agree to wear a helmet that satisfies CPSC standards for the entirety of my participation in Bike for Change.
I agree that the Releasees are not responsible for any personal items or property lost or stolen before, during, or after the Bike for Change.
Medical Evaluation
I attest that I (or my child) am medically and physically able to participate in the Bike for Change. If I experience any doubt as to my (or my child’s) ability to successfully and safely participate in and/or complete Bike for Change, I take full responsibility for consulting a physician. I attest that, if I (or my child) am pregnant, disabled in any way, or have recently suffered an illness, injury, or impairment, I (or my child) should have or did consult a physician prior to participating in the Bike for Change.
I consent to emergency medical care and transportation in the event of injury to me (or my child) as medical professionals may deem appropriate. This Release extends to any liability arising out of or in any way connected with the medical treatment and transportation provided in the event of an emergency, including, but not limited to, negligent emergency rescue operations.
Voluntary Participation
I am fully aware of the risks connected with participation in the Bike for Change, whether specifically listed in this Release or not, and I voluntarily elect to participate in the Bike for Change knowing that this participation involves these risks. I understand that my participation in the Bike for Change accompanies a fundraising event for Forget Me Not Advocacy Group.
Assumption of Risk, Waiver of Liability, Release, and Covenant Not To Sue
In consideration for being permitted to participate in the Bike for Change, I voluntarily agree for myself, my family, heirs, assigns, executors, and administrators to the following:
- TO ASSUME FULL RESPONSIBILITY FOR ANY RISKS OF LOSS, OR PERSONAL INJURY, INCLUDING DEATH that may be sustained by me (or my child), or any loss or damage to property owned by me (or my child), as a result of participating in the Bike for Change.
- TO RELEASE, WAIVE, HOLD HARMLESS, DISCHARGE, AND COVENANT NOT TO SUE the Releasees from any and all liability, claims, actions, demands, expenses, attorney fees, breach of contract actions, breach of statutory duty or other duty of care, warranty, strict liability actions, and causes of action whatsoever, that I might have or may acquire in the future, arising out of or related to any loss, damage, or injury, including death, that may be sustained by me (or my child), or to any property belonging to me (or my child), while participating in the Bike for Change including, but not limited to, any claim that the act or omission complained of was in whole or in part by the negligence or carelessness of the Releasees.
Acknowledgment and Compliance with Rules
I agree to observe all rules and safety procedures that accompany the Bike for Change and to abide by any decision of an event official relative to my (or my child’s) ability to safely participate in the event. I agree to exhibit appropriate behavior at all times and to obey all laws. Forget Me Not Advocacy Group and event officials may dismiss me (or my child), without refund, should my (or my child’s) behavior endanger the safety of or negatively affect an event, person, facility, or property of any kind.
Severability
I agree that if any portion of this Release is deemed to be invalid, the remainder of the Release will still be binding and enforceable.
Photography Release
I hereby grant full permission to Forget Me Not Advocacy Group to use, reuse, reproduce, publish, or republish any photographs, motion pictures, recordings, or any other record of my participation in this event, in any medium now known or hereafter developed, alone or in conjunction with other material, without restriction as to changes or alterations, as well as to use my name, voice, likeness, and/or other indicia of identity, for editorial, educational, promotional, advertising, and commercial purposes, including without limitation in connection with the solicitation of contributions and the furtherance of the corporate objectives of Forget Me Not Advocacy Group. Further, I relinquish all rights, title, and interest in any and all photographs, motion pictures, recordings, or other records of the Bike for Change I may take or capture to Forget Me Not Advocacy Group.
I acknowledge and represent that I have carefully read and understand all terms of this Release and Waiver of Liability.
Full Name: __________________________________________________
Signature: ___________________________________________________
Date: ______________________
Print Name of Guardian (if under 18): _____________________________________
Signature of Guardian: ________________________________________________
Forget Me Not Advocacy Group 