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*Once completed, save email confirmation to present to Pedal Wagon Captain along with valid ID on cruise day!*

Today's Date: November 18, 2018

Liability Waiver

I understand that operating and riding the Pedal Wagon is a potentially dangerous activity. I assume the risk that I may be seriously injured and/or injure someone else while using the Pedal Wagon. I assume all risks associated with my use of the Pedal Wagon, and will not bring any action against Unplugged LLC, or any of its subsidiaries, owners, managers, officials, agents, employees, volunteers, successors, or assigns (together with Unplugged LLC, the "Releasees"), for personal injury, property loss, or property damage, including any action for negligence, breach of warranty, product liability, or strict liability. I further agree to release, indemnify and hold harmless the owners Releasees and manufacturers of the Pedal Wagon from any liability against any and all claims, including damages or demands of third parties as a result of my use of the Pedal Wagon, whether caused by the negligence of the Releasees or otherwise.

While riding the Pedal Wagon, customers are subject to being in images that may be used for marketing purposes. I hereby grant the Pedal Wagon permission to use my likeness in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications, without payment or other consideration. I understand and agree that all photos will become the property of the Pedal Wagon and will not be returned. I hereby irrevocably authorize the Pedal Wagon to edit, alter, copy, exhibit, publish, or distribute these photos for any lawful purpose. In addition, I waive any right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photo. I hereby hold harmless, release, and forever discharge the Pedal Wagon from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.

All city, state, and federal laws and rules apply to Pedal Wagon passengers before, during, and after Pedal Wagon cruises and I acknowledge and agree that any violation of any of such laws or rules shall be within the scope of the foregoing sentence. Without limiting the foregoing, I specifically acknowledge and agree that the State of Kentucky imposes limitations on the amount of alcohol that a person may possess while on the Pedal Wagon and that I will comply with such limitations at all times during my use of the Pedal Wagon.

Inappropriate behavior before, during, and after cruises will result in the offending passenger(s) being asked to un-board the Pedal Wagon, and the passenger's subsequent responsibility to find their own way home. Behavior considered "inappropriate" is left to the discretion of the Pedal Wagon Guide.

Inappropriate behavior includes, but is not limited to:

  • Possession of an open container of alcohol while on the Pedal Wagon in excess of the limitations established by the State of Kentucky.
  • Possession of liquor, or liquor based items such as jello shots, gummy bears, pre-mixed drinks, and consealed containers such as plastic bottles and flasks
  • Excessive intoxication (vomiting, falling off, etc)
  • Excessive Loudness
  • Public urination, indecent exposure 
  • Verbal or physical harassment of other riders, the Guide, or third parties
  • Refusal to yield to the requests of the Pedal Wagon Guide
  • Physically endangering themselves by acting careless on the bike (i.e. jumping off the moving Pedal Wagon, pushing others, etc.)

All city, state, and federal laws and rules apply to Pedal Wagon passengers before, during, and after Pedal Wagon cruises. At no time during my use of the Pedal Wagon will I allow myself to be in an excessively intoxicated condition. Any person arriving in an intoxicated condition shall not be allowed on the Pedal Wagon.

First Rider's Name

First Name*

Last Name*
First Rider's Date of Birth*
First Rider's Information

Your Cruise Date: What day is your cruise scheduled for? *
I will have the option to wear a helmet, and I will...*

We always have helmets on board for those that want to wear them.

Select Your Gender*

Check each:

I will not *
Get off the Pedal Wagon while it is moving.
I will not *
Disrespect other riders and passersby by using abusive language.
I understand *
Failure to obey the rules may lead to the end of my time on the Pedal Wagon without refund.
I understand *
Kentucky law prohibits open containers of alcohol while on public property and not on the Pedal Wagon.
I understand *
Kentucky law prohibits any person from having in his or her possession in excess of either thirty-six ounces of 8%ABV beer or eighteen ounces of wine while on the Pedal Wagon

Print Name as it appears on your Government Issued ID *
First Rider's Signature*
Second Rider's Name

First Name*

Last Name*
Second Rider's Date of Birth*
Second Rider's Information

Your Cruise Date: What day is your cruise scheduled for? *
I will have the option to wear a helmet, and I will...*

We always have helmets on board for those that want to wear them.

Select Your Gender*

Check each:

I will not *
Get off the Pedal Wagon while it is moving.
I will not *
Disrespect other riders and passersby by using abusive language.
I understand *
Failure to obey the rules may lead to the end of my time on the Pedal Wagon without refund.
I understand *
Kentucky law prohibits open containers of alcohol while on public property and not on the Pedal Wagon.
I understand *
Kentucky law prohibits any person from having in his or her possession in excess of either thirty-six ounces of 8%ABV beer or eighteen ounces of wine while on the Pedal Wagon

Print Name as it appears on your Government Issued ID *
Third Rider's Name

First Name*

Last Name*
Third Rider's Date of Birth*
Third Rider's Information

Your Cruise Date: What day is your cruise scheduled for? *
I will have the option to wear a helmet, and I will...*

We always have helmets on board for those that want to wear them.

Select Your Gender*

Check each:

I will not *
Get off the Pedal Wagon while it is moving.
I will not *
Disrespect other riders and passersby by using abusive language.
I understand *
Failure to obey the rules may lead to the end of my time on the Pedal Wagon without refund.
I understand *
Kentucky law prohibits open containers of alcohol while on public property and not on the Pedal Wagon.
I understand *
Kentucky law prohibits any person from having in his or her possession in excess of either thirty-six ounces of 8%ABV beer or eighteen ounces of wine while on the Pedal Wagon

Print Name as it appears on your Government Issued ID *
Fourth Rider's Name

First Name*

Last Name*
Fourth Rider's Date of Birth*
Fourth Rider's Information

Your Cruise Date: What day is your cruise scheduled for? *
I will have the option to wear a helmet, and I will...*

We always have helmets on board for those that want to wear them.

Select Your Gender*

Check each:

I will not *
Get off the Pedal Wagon while it is moving.
I will not *
Disrespect other riders and passersby by using abusive language.
I understand *
Failure to obey the rules may lead to the end of my time on the Pedal Wagon without refund.
I understand *
Kentucky law prohibits open containers of alcohol while on public property and not on the Pedal Wagon.
I understand *
Kentucky law prohibits any person from having in his or her possession in excess of either thirty-six ounces of 8%ABV beer or eighteen ounces of wine while on the Pedal Wagon

Print Name as it appears on your Government Issued ID *
Fifth Rider's Name

First Name*

Last Name*
Fifth Rider's Date of Birth*
Fifth Rider's Information

Your Cruise Date: What day is your cruise scheduled for? *
I will have the option to wear a helmet, and I will...*

We always have helmets on board for those that want to wear them.

Select Your Gender*

Check each:

I will not *
Get off the Pedal Wagon while it is moving.
I will not *
Disrespect other riders and passersby by using abusive language.
I understand *
Failure to obey the rules may lead to the end of my time on the Pedal Wagon without refund.
I understand *
Kentucky law prohibits open containers of alcohol while on public property and not on the Pedal Wagon.
I understand *
Kentucky law prohibits any person from having in his or her possession in excess of either thirty-six ounces of 8%ABV beer or eighteen ounces of wine while on the Pedal Wagon

Print Name as it appears on your Government Issued ID *
Sixth Rider's Name

First Name*

Last Name*
Sixth Rider's Date of Birth*
Sixth Rider's Information

Your Cruise Date: What day is your cruise scheduled for? *
I will have the option to wear a helmet, and I will...*

We always have helmets on board for those that want to wear them.

Select Your Gender*

Check each:

I will not *
Get off the Pedal Wagon while it is moving.
I will not *
Disrespect other riders and passersby by using abusive language.
I understand *
Failure to obey the rules may lead to the end of my time on the Pedal Wagon without refund.
I understand *
Kentucky law prohibits open containers of alcohol while on public property and not on the Pedal Wagon.
I understand *
Kentucky law prohibits any person from having in his or her possession in excess of either thirty-six ounces of 8%ABV beer or eighteen ounces of wine while on the Pedal Wagon

Print Name as it appears on your Government Issued ID *
Seventh Rider's Name

First Name*

Last Name*
Seventh Rider's Date of Birth*
Seventh Rider's Information

Your Cruise Date: What day is your cruise scheduled for? *
I will have the option to wear a helmet, and I will...*

We always have helmets on board for those that want to wear them.

Select Your Gender*

Check each:

I will not *
Get off the Pedal Wagon while it is moving.
I will not *
Disrespect other riders and passersby by using abusive language.
I understand *
Failure to obey the rules may lead to the end of my time on the Pedal Wagon without refund.
I understand *
Kentucky law prohibits open containers of alcohol while on public property and not on the Pedal Wagon.
I understand *
Kentucky law prohibits any person from having in his or her possession in excess of either thirty-six ounces of 8%ABV beer or eighteen ounces of wine while on the Pedal Wagon

Print Name as it appears on your Government Issued ID *
Eighth Rider's Name

First Name*

Last Name*
Eighth Rider's Date of Birth*
Eighth Rider's Information

Your Cruise Date: What day is your cruise scheduled for? *
I will have the option to wear a helmet, and I will...*

We always have helmets on board for those that want to wear them.

Select Your Gender*

Check each:

I will not *
Get off the Pedal Wagon while it is moving.
I will not *
Disrespect other riders and passersby by using abusive language.
I understand *
Failure to obey the rules may lead to the end of my time on the Pedal Wagon without refund.
I understand *
Kentucky law prohibits open containers of alcohol while on public property and not on the Pedal Wagon.
I understand *
Kentucky law prohibits any person from having in his or her possession in excess of either thirty-six ounces of 8%ABV beer or eighteen ounces of wine while on the Pedal Wagon

Print Name as it appears on your Government Issued ID *
Ninth Rider's Name

First Name*

Last Name*
Ninth Rider's Date of Birth*
Ninth Rider's Information

Your Cruise Date: What day is your cruise scheduled for? *
I will have the option to wear a helmet, and I will...*

We always have helmets on board for those that want to wear them.

Select Your Gender*

Check each:

I will not *
Get off the Pedal Wagon while it is moving.
I will not *
Disrespect other riders and passersby by using abusive language.
I understand *
Failure to obey the rules may lead to the end of my time on the Pedal Wagon without refund.
I understand *
Kentucky law prohibits open containers of alcohol while on public property and not on the Pedal Wagon.
I understand *
Kentucky law prohibits any person from having in his or her possession in excess of either thirty-six ounces of 8%ABV beer or eighteen ounces of wine while on the Pedal Wagon

Print Name as it appears on your Government Issued ID *
Tenth Rider's Name

First Name*

Last Name*
Tenth Rider's Date of Birth*
Tenth Rider's Information

Your Cruise Date: What day is your cruise scheduled for? *
I will have the option to wear a helmet, and I will...*

We always have helmets on board for those that want to wear them.

Select Your Gender*

Check each:

I will not *
Get off the Pedal Wagon while it is moving.
I will not *
Disrespect other riders and passersby by using abusive language.
I understand *
Failure to obey the rules may lead to the end of my time on the Pedal Wagon without refund.
I understand *
Kentucky law prohibits open containers of alcohol while on public property and not on the Pedal Wagon.
I understand *
Kentucky law prohibits any person from having in his or her possession in excess of either thirty-six ounces of 8%ABV beer or eighteen ounces of wine while on the Pedal Wagon

Print Name as it appears on your Government Issued ID *
Parent or Guardian's Email Address

Email*

Confirm Email*
As a token of our appreciation, we send special offers to our previous customers.
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*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Your Cruise Date: What day is your cruise scheduled for? *
I will have the option to wear a helmet, and I will...*

We always have helmets on board for those that want to wear them.

Select Your Gender*

Check each:

I will not *
Get off the Pedal Wagon while it is moving.
I will not *
Disrespect other riders and passersby by using abusive language.
I understand *
Failure to obey the rules may lead to the end of my time on the Pedal Wagon without refund.
I understand *
Kentucky law prohibits open containers of alcohol while on public property and not on the Pedal Wagon.
I understand *
Kentucky law prohibits any person from having in his or her possession in excess of either thirty-six ounces of 8%ABV beer or eighteen ounces of wine while on the Pedal Wagon

Print Name as it appears on your Government Issued ID *
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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