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Accident Waiver and Release of Liability - RCR Programs 2020

In submitting this Waiver, each of the undersigned confirms that he or she will hold harmless and indemnify, in the case of accident, injury or damage to the undersigned or his or her property of any kind, Routt County Riders (RCR), its officers, directors members and volunteers (the indemnified parties) and states as follows: I recognize that bicycling and laboring on bicycle trails are inherently dangerous activities and I represent that I am competent to use my and RCR’s equipment safely. I understand that I participate in RCR activities at my own risk. I recognize that my safety and the safety of those for whom I am responsible is my personal responsibility and that I will rely upon my own personal insurance in the case of accident, injury, illness or damage to me, those for whom I am responsible and our property. I agree to hold the indemnified parties harmless and indemnify them for all costs, judgments and awards that may be claimed against them together with the reasonable costs to defend such claims, including attorneys’ and expert witness fees, brought by myself or another on my behalf or others against me. A Parent or Guardian must sign this Waiver for participants under 18 years old. Due to RCR's insurance requirements and the inherent risks of cycling, RCR requires one Parent, Guardian or responsible adult to attend and supervise every group of four children or less 14 years of age or under attending any RCR Event. 

Additionally, check this box:

I Agree
....if you agree to potentially having your photo taken during RCR programs/activities (or photos of the minors for whom you are completing this waiver) and used in promotional materials and outreach in the future.

Please include contact information for updates on future trail work days and other cycling events.

 

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's RCR Member Status
Are you a current RCR member?*
No
Yes
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's RCR Member Status
Are you a current RCR member?*
No
Yes
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's RCR Member Status
Are you a current RCR member?*
No
Yes
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's RCR Member Status
Are you a current RCR member?*
No
Yes
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's RCR Member Status
Are you a current RCR member?*
No
Yes
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's RCR Member Status
Are you a current RCR member?*
No
Yes
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's RCR Member Status
Are you a current RCR member?*
No
Yes
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's RCR Member Status
Are you a current RCR member?*
No
Yes
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's RCR Member Status
Are you a current RCR member?*
No
Yes
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's RCR Member Status
Are you a current RCR member?*
No
Yes
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to join the RCR Monthly(ish) Newsletter List!
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
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*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's RCR Member Status
Are you a current RCR member?*
No
Yes
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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