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Tour Orientation Checklist, Release & Hold Harmless, and Photo Release

Tour Orientation Checklist

1. Provided an opportunity to review the Safety Video and/or Getting Started Manual
2. Wear a helmet Operation of the Segway PT

These items were provided to me.

I Agree

Operation of the Segway PT

3. Slowly and smoothly step on the Segway PT
4. Step down from the Segway PT without moving the machine and while keeping the platform level
5. Move forward, backward, remain stationary
6. Turn in place
7. Execute a controlled stop
8. Execute smooth, controlled, leaning turns
9. Always leave a gap between the body and the handlebar
10. No taking of photographs from the platform of the Segway PT

These items were explained to me and I understand how to perform each operational skill.

I Agree

Safety Features

11. Recognize the Speed Limiter and respond by slowing down
12. Recognize the Stick Shake Warning and respond by slowing down or stopping and stepping off
13. Recognize the Safety Shutdown and respond by stepping off safely within 10 seconds and stay off
14.Never let go of the machine while it is in Balance Mode
15. Anticipate and avoid slips, trips and tips
16. Keep both hands and feet on the Segway PT

I understand the safety features

I Agree

17. Riders must not be under the influence of alcohol or drugs or suffer any impairment to balance
18. Riders must meet the age requirement (12 years or older)
19. Riders must not be pregnant

I meet these safety requirements

I Agree

I recognize that this Tour Orientation is a partial introduction to the features and functions of the Segway PT and is NOT the complete Product Orientation provided to Segway PT purchasers who use their machines independent of a Segway Tour Guide. I acknowledge that I need to ride conservatively, avoid abrupt maneuvers, and avoid riding in any area designated "off limits" by the Tour Operator.

I Agree

 

Release & Hold Harmless

READ CAREFULLY BEFORE SIGNING

In consideration of Chairo LLC d/b/a iRide Nashville allowing me to participate in a Segway Human Transporter tour operated by Chairo LLC d/b/a iRide Nashville (“Tour”), I agree and acknowledge on behalf of myself, and the minor child for whom I am the parent or legal guardian (listed below), as follows:

I hereby assume the any and all risks incidental to and arising from participating in the Tour, including but not limited to falling from or being hit by a Segway Human Transporter (“Segway HT”), which risks may include, among other things, muscle injuries, broken bones, lacerations, serious injury, and/or death. I acknowledge and agree that the Tour participation of me or my child is entirely voluntary.

The released parties are: Chairo, LLC d/b/a iRide Nashville, related and affiliated companies (including Landlords), and the officers, directors, employees, agents, representatives, successors and assigns of each of the foregoing entities. On my own behalf and on behalf of any minor child for whom I am parent or legal guardian (listed below), and on behalf of my and their heirs, executors, personal representatives, administrators and assigns, I (1) release and forever discharge the Released Parties of and from all liabilities, claims, actions, damages, costs or expenses of any nature whatsoever for bodily injury (including death) and property damage arising out of or in any way connected with such Tour participation, even if such injury, loss, or damage is caused by the negligence of the Released Parties or the negligent operation of the Tour; and (2) indemnify and hold each of the Released Parties harmless against any and all such liabilities, claims, actions, damages, costs or expenses, including, but not limited to, all attorney's fees and costs. I expressly agree that this release and indemnity agreement includes, without limitation, any claims based on the negligence, action or inaction of any of the Released Parties, and covers bodily injury (including death) and property damage, whether suffered by me or any minor child for whom I am parent or legal guardian (listed below) before, during or after such Tour participation.

I hereby authorize medical treatment for me and the minor child for whom I am parent or legal guardian (listed below), at my cost, if the need arises.  However, I acknowledge and agree that the Released Parties shall have no duty, obligation or liability arising out of the provision of or failure to provide medical treatment.

In connection with such Tour participation, I further grant the Released Parties the right to photograph, videotape or otherwise record images of the minor child for whom I am parent or legal guardian (who is listed below), and further to use said child’s name, face, likeness, voice and appearance in connection with exhibitions, publications (including Facebook), advertising and promotional materials without reservation or limitation. The Released Parties are, however, under no obligation to exercise the rights granted in this paragraph.

I agree that any claim which I may bring forward at any time for any reason against the Releases shall be governed by the laws of Tennessee and the parties submit to the exclusive jurisdiction and venue of the courts of Davidson County, Tennessee, and none other. I also understand that if any part of this Agreement is determined to be unenforceable, all other parts shall be given full force and effect.

I acknowledge and agree that any liability of the Release Parties shall not exceed the amount of the payment received by the Release Parties from me for participation in the Tour.

GlideNow LLC requires the use of a helmet when riding a Segway HT on the Tour. I certify I am 18 years of age or older, I am the parent or legal guardian of the minor child listed below, that neither I, nor any minor child below, is under the influence of alcohol or drugs and that there is no impairment or imbalance that would affect operation of the Segway HT or participation in the Tour, and I understand all the terms of this Agreement.

I HAVE READ THIS DOCUMENT AND UNDERSTAND IT. I FURTHER UNDERSTAND THAT BY SIGNING THIS RELEASE, I VOLUNTARILY SURRENDER CERTAIN LEGAL RIGHTS. I HAVE ALSO READ AND INITIALED THE TOUR ORIENTATION CHECKLIST FOR RIDERS.

Whereof, this Release and Hold Harmless Agreement has been executed by the parties hereto on the date set forth below their respective signature hereto, effective as of: August 24, 2019

First Guest's Name

First Name*

Last Name*

Phone*
First Guest's Date of Birth*
I certify that I am 18 years of age or older
First Guest's Signature*
Second Guest's Name

First Name*

Last Name*
Second Guest's Date of Birth*
Third Guest's Name

First Name*

Last Name*
Third Guest's Date of Birth*
Fourth Guest's Name

First Name*

Last Name*
Fourth Guest's Date of Birth*
Fifth Guest's Name

First Name*

Last Name*
Fifth Guest's Date of Birth*
Sixth Guest's Name

First Name*

Last Name*
Sixth Guest's Date of Birth*
Seventh Guest's Name

First Name*

Last Name*
Seventh Guest's Date of Birth*
Eighth Guest's Name

First Name*

Last Name*
Eighth Guest's Date of Birth*
Ninth Guest's Name

First Name*

Last Name*
Ninth Guest's Date of Birth*
Tenth Guest's Name

First Name*

Last Name*
Tenth Guest's Date of Birth*
Guest's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
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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