2010 USA Cycling Standard Athlete's Entry Blank
Release Form and Wheelsport Cycling Team Day-of-Event-Only Club Membership:
Track Training Session at Marymoor Velodrome, Redmond, WA
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Name:__________________ Athlete's Entry and Release Form TO WHEELSPORT CYCLING TEAM: Please accept my day-of-event-only Club membership and Entry for the road training session Date:___________________ I ACKNOWLEDGE THAT BY SIGNING THIS DOCUMENT, I AM RELEASING WHEELSPORT C.T., MARYMOOR VELODROME ASSOC,USA CYCLING, INC. (USAC), THE UNITED STATES CYCLING FEDERATION (USCF), NATIONAL OFF ROAD BICYCLE ASSOCIATION (NORBA), NATIONAL COLLEGIATE CYCLING ASSOCIATION (NCCA), AND U.S. PROFESSIONAL RACING ORGANIZATION (USPRO) AND THEIR RESPECTIVE AGENTS, EMPLOYEES, MEMBERS, SPONSORS, PROMOTERS AND AFFILIATES (COLLECTIVELY "RELEASEES") FROM LIABILITY. THIS ENTRY BLANK AND RELEASE IS A CONTRACT WITH LEGAL CONSEQUENCES. I HAVE BEEN ADVISED TO READ IT CAREFULLY BEFORE SIGNING. In consideration of the Releasees or USAC's issuance of a license to me or the acceptance of my application for entry in the above event, I hereby freely agree to and make the following contractual representations and agreements acknowledge that cycling is an inherently dangerous sport and fully realize the dangers of participating in a bicycle race and FULLY ASSUME THE RISKS ASSOCIATED WITH SUCH PARTICIPATION INCLUDING, by way of example, and not limitation, the following: the dangers of collision with pedestrians, vehicles, other cyclists, and fixed or moving objects; the dangers arising from surface hazards, equipment failure, inadequate safety equipment,THE RELEASEES' OWN NEGLIGENCE, and weather conditions; and the possibility of serious physical and/or mental trauma or injury associated with athletic cycling training. For myself, my heirs, executors, administrators, legal representatives, assignees, and successors in interest (collectively "Successors")
I HEREBY WAIVE, RELEASE, DISCHARGE, HOLD HARMLESS, AND PROMISE TO INDEMNIFY AND NOT TO SUE |
the Releasees and the sponsors of this event, the organizer 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, (the foregoing are also collectively deemed to be Releasees),FROM ANY and all rights and CLAIMS INCLUDING CLAIMS ARISING FROM THE RELEASEES' OWN NEGLIGENCE , which I have or which may hereafter accrue to me and from any and all damages which may be sustained by me directly or indirectly in connection with, or arising out of, my participation in or association with the event, or travel to or return from the event. I agree it is my sole responsibility to be familiar with the roads and the rules governing their use,the Releasee's rules, and any special training rules. I understand and agree that situations may arise during the training which may be beyond the immediate control of the Club or training officials or organizers, and I must continually ride so as to neither endanger myself nor others. I accept responsibility for the condition and adequacy of all of my equipment. I will always wear an approved helmet while training which can protect me against serious head injury, and assume all responsibility and liability for the selection of such a helmet. I have no physical or medical 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 this event. I agree, for myself and my 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, the asserting party 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 other provision herein or as a consent to any subsequent waiver or modification. Every term and provision of this agreement is intended to be severable. If any one or more of them is found to be unenforceable or invalid, that shall not affect the other terms and provisions, which shall remain binding and enforceable. |
Today's date: _______________ Date of Birth: _______________ Club/Team WHEELSPORT CYCLING TEAM Name(print):_______________________ Phone#:__________________________ E-Mail:___________________________ Street:___________________________ City:________State:____ Zip:_________ Who to notify in caseof emergency: _________________________________ Phone # ________________________ Signature of entrant ______________________________Consent and Release of Parent or Guardian I am the parent or guardian of _____________________(Child). My Child is fit for the race training and I consent to my Child's participation. I HAVE READ AND I UNDERSTAND THE ATHLETE'S COMPETITION AND RELEASE AGREEMENT. In consideration of allowing my Child to participate, I consent to it and agree that ITS TERMS SHALL LIKEWISE BIND ME, MY CHILD, my heirs, legal representatives, and assignees. I HEREBY RELEASE AND SHALL DEFEND, INDEMNIFY AND HOLD HARMLESS THE RELEASEES FROM EVERY CLAIM AND ANY LIABILITY that I or my Child may allege against the Releasees (including reasonable attorney's fees or costs) as a direct or indirect result of injury to me or my Child because of my Child's participation in the Race, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES or others. I PROMISE NOT TO SUE RELEASEES on my behalf or on behalf of my Child regarding any claim arising from my Child's participation in the Race. Signature of parent or guardian__________________ Date______________________________ |