In consideration of the acceptance of my application
for entry in the above events, I hereby freely agree to and take the following
contractual representations and agreements.
I fully
realize the dangers of participating in a bicycle riding/racing and fully assume
the risks associated with such participation including, by way of example, and
not limitation, the following: the danger of collision with pedestrians,
vehicles, other riders, and fixed or moving objects; the dangers arising from
surface hazards, equipment failure, inadequate safety equipment, and weather
conditions; and the possibility of serious physical and/or mental trauma
associated with cycling.
I hereby waive, release,
and discharge for myself, my heirs, executors, administrators, legal
representatives, assigns, and successors in interest (hereinafter collectively
"successors") any and all rights and claims which I have or which may accrue to
me against the sponsors of these events, the United States Cycling Federation,
the promoter and any promoting organizations, property owners, law enforcement
agencies, all public entities, special districts, and properties (and their
respective agents, officials, and employees) through or by which the events will
be held for any and all damages which may sustained by me directly or indirectly
in connection with, or arising out of, my participation in or association with
the events, or travel to or return from the events.
I agree it is my sole responsibility to be familiar with the ride/race routes,
and any special regulations for the events. I understand and agree that
situations may arise during the rides which may be beyond the immediate control
of the ride officials or organizers, and I must continually ride so as to
neither endanger myself or others. I accept responsibility for the condition and
adequacy of my competition equipment. I will compete wearing a helmet which
satisfies the requirements of the USCF Racing Rules and that can protect against
serious head injury, and assume all responsibility and liability for the
selection of such a helmet. I have no physical or mental condition which, to my
knowledge, would endanger myself or others if I participate in this event, or
would interfere with my ability to participate in these events.
I agree, for myself and successors, that the above
representations are contractually binding, and are not mere recitals, and that
should I or my successors assert my claim in contravention of this agreement, I
or my successors shall be liable for the expenses (including legal fees)
incurred by the other party or parties in defending, unless the other party or
parties are finally adjudged liable on such claim for willful and wanton
negligence. This agreement may not be modified orally, and a waiver of any
provision shall not be construed as a modification of any other provision herein
or as a consent to any subsequent waiver or modification.
PARENT or
GUARDIAN of a Minor: I as parent or guardian of the below named minor,
hereby give my permission for my child or ward to participate in the event, and
further agree, individually and on behalf of my child or ward, to the terms of
the above.
Today's Date | Racing Age | ||
USCF Club: Wheelsport Cycling Team. | USCF License No. ACA License No. | ||
Name | |||
Street | |||
City | State | Zip | |
Who to notify in case of an emergency | Phone | ||
Signature of entrant | |||
Signature of Parent or Guardian of minor |