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MOUNTAIN BIKE SHUTTLE SERVICE ASSUMPTION OF RISK ANDLIABILITY /WAIVER OF CLAIMS AND INDEMNITY AGREEMENT /DECLARATION OF FITNESS AGREEMENT

Today's Date:October 21, 2018

Please read and be certain you understand the implications of signing.

 

Participant understands signed waiver is valid for any Mountain Bike Shuttle Service for our current season.

I Agree

 

Assumption of Risk Associated with Mountain Bike Shuttle Service activities:

I do hereby affirm and acknowledge that I have been fully informed of the inherent hazards and risks associated with the use of the mountain bike shuttle service. Inherent hazards and risks include but are not limited to:

  1. Risk of injury from the activitiesand equipment utilized is significant including the potential for permanent disability or death.
  2. Possible equipment failure and/or malfunction of my own or other's equipment.
  3. Possible equipment damage from transporting via shuttle trailer.
  4. I AGREE THAT I WILL WEAR A HELMET AT ALL TIMES. However, a helmet cannot guarantee the participant's safety. I further agree that no helmet can protect the wearer against all potential head injuries or prevent injury to the wearer's face, neck or spinal cord.
  5. Changes in terrain, encountering rocks, trees, debris, fences, sign posts, stumps, bridges, boardwalks, roads, pathways, ramps, jumps, other persons, traffic and other natural and man-made hazards.
  6. My own negligence and/or the negligence of others, including but not limited to operator error.
  7. Broken bones, severe injuries to the head, neck and back which may result in severe impairment, permanent disability or even death.
  8. Cold weather and heat-related injuries and illness including but not limited to frostnip, frost bite, hypothermia, heat exhaustion, heat stroke, sunburn and dehydration.
  9. Exposure to outdoor elements, including but not limited to inclement weather, thunder and lighting, severe and/or varied wind, temperature or weather conditions.
  10. Attack by or encounter with insects, animals and/or wildlife. PLEASE NOTE: If paticipant(s) use an INHALER and/or require EPINEPHRINE (EpiPen),they are responsible for bringing their medication for self-administration during the entire tour duration. Keweenaw Adventure Company, LLCDOES NOT provide INHALER or EPINEPHRINE (EpiPen) medications.
  11. Accidents or illness occurring in remote places where there are no available medical facilities and rescue may be distant and time-consuming at best.
  12. Fatigue chill and/or dizziness, which may diminish my/our reaction time and increase the risk of accident.
  13. My sense of balance, physical coordination, and ability to follow instructions.

*I understand the description of these risks is not complete and that unknown or unanticipated risks may result in injury, illness, or death.

 

Release of Liability, Waiver of Claims and Indemnity Agreement:
In consideration for being permitted to participate in mountain bike shuttle service activities, I hereby agree, acknowledge and appreciate that:

  1. I HEREBY RELEASE AND HOLD HARMLESS WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER CAUSED BY NEGLIGENCE OR OTHERWISE, the following named persons or entities, herein referred to as releasees: Keweenaw Adventure Company, LLC.
  2. Keweenaw Adventure Company LLC does not have liability insurance coverage for its customers being transported in its vehicle. I assume all responsibility for all damage to personal property, bodily injury or even loss of life in the event of an accident.
  3. To release the releasees, their officers, directors, employees, representatives, agents and volunteers from liability and responsibility whatsoever and for any claims or causes of action that I, my estate, heirs, survivors, executors, or assigns may have for personal injury, property damage, or wrongful death arising from the above activities whether caused by active or passive negligence of the releases or otherwise. By executing this document, I agree to hold the releases harmless and indemnify them in conjunction with any injury, disability, death or loss or damage to person or property that may occur as a result of engaging in the above activities.
  4. By entering into the Agreement, I am not relying on any oral or written representation or statements made by the releasees, other then what is set forth in this Agreement.

This release shall be binding to the fullest extent permitted by law. If any provision of this release is found to be unenforceable, the remaining terms shall be enforceable.

 

Declaration of Fitness Agreement:
Furthermore, I hereby declare that I am physically fit and that I have no physical or mental condition(s) that should preclude me from participating in my chosen activity, that I am not participating against medical advice or treatment and that I have not been diagnosed by a registered doctor as having a terminal illness. I further declare that in the event that I feel ill or unwell, have any physical complaints whatsoever or if an injury is sustained of any kind during the course of Mountain Bike Shuttle activities, I will notify an instructor/guide (if applicable) immediately and before moving away from the immediate vicinity.

 

*I HAVE READ THEASSUMPTION OF RISK / RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT/ DECLARATION OF FITNESS AGREEMENT, AND I FULLY UNDERSTAND ITS TERMS, AND UNDERSTAND THAT I HAVE GIVEN UP LEGAL RIGHTS BY SIGNING IT, AND I SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

First Participant's Name

First Name*

Last Name*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Emergency Contact (Optional):

Name & Number
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Emergency Contact (Optional):

Name & Number
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Emergency Contact (Optional):

Name & Number
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Emergency Contact (Optional):

Name & Number
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Emergency Contact (Optional):

Name & Number
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Emergency Contact (Optional):

Name & Number
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Emergency Contact (Optional):

Name & Number
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Emergency Contact (Optional):

Name & Number
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Emergency Contact (Optional):

Name & Number
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Emergency Contact (Optional):

Name & Number
Parent or Guardian's Email Address

Email*

Confirm Email*
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Your Home City
Your State's Abbreviation
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Select one of the following:*
FOR PARTICIPANTS OF MINORITY AGE: This is to certify that , as Parent, Guardian or Temporary Guardian with legal responsibility for this participant, do consent and agree not only to his/her release of all Releasees, but also to release and indemnify the Releasees from any and all liabilities incident to his/her involvement in these programs for myself, my heirs, assigns, and next of kin.
Parent or Guardian's Name

First Name*

Last Name*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Emergency Contact (Optional):

Name & Number
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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