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2020 Cannonball Fall Participant Waiver

AGREEMENT ASSUMING ALL RISKS AND RELEASING LIABILITY

I acknowledge:

  1. That I am competent to perform a safety check and will personally perform a safety check of the bicycle I will ride at all Bike Surgeon events prior to my ride/race.
    I Agree
  2. That I am participating in an event where my safety is completely my responsibility, the event happens on open roads and is self-guided, and I have the requisite skills to complete the event safely. 
    I Agree
  3. That I am competent to safely ride the bicycle and compete in the event. While participating at Bike Surgeon rides and events I will observe safe riding practices and obey all laws and guidelines. I am also healthy enough for vigorous exercise (please consult your physician prior to participation).
    I Agree
  4. That I will always wear all appropriate safety equipment, including a bicycle helmet when riding. That I will comply with all rules of the road and am aware of the dangers of riding a bicycle on roads that also include regular vehicular traffic. 
    I Agree
  5. That bicycling and all other activities at Bike Surgeon events are inherently dangerous, presenting a great number of risks, such as the risk of falling, colliding with other riders, automotive traffic on roads, encountering hidden obstacles or varying terrain, or the risk of injury from any failure of the bicycle or any of its components.
    I Agree
  6. The undersigned understands that exposure to disease-causing organisms, such as COVID-19, and contaminated objects, as well as personal contact with other parties, including but not limited to organizers, other participants, others on route, and anything you might encounter could result in illness, permanent disability, transmission to others or death.  By signing below, I agree to release and hold-harmless Bike Surgeon, and any and all other event Sponsors and Hosts and all of their agents, contractors, employees, officers, and vendors from and against all claims for damages and liability resulting from exposure to disease-causing organisms, such as COVID-19, and contaminated objects, as well as personal contact associated with participating in any and all Bike Surgeon events. I understand that the Event and its representatives cannot guarantee that any precautionary measures taken will fully protect anyone from being exposed to and/or contracting COVID-19 or any other contagion.
    I Agree
  7. That I freely and expressly accept all risks associated with bicycling and other event participation, including all risks of injury or death. ON MY OWN BEHALF, AND ON THE BEHALF OF MY HEIRS, ASSIGNS, AND PERSONAL REPRESENTATIVES, I HEREBY FULLY AND FOREVER DISCHARGE AND RELEASE THE BIKE SURGEON INC., NGJ, LLC dba BIKE SURGEON, AND THEIR OWNERS, VENDORS, SUPPLIERS, EMPLOYEES, AGENTS, SPONSORS, INSURERS, CUSTOMERS AND ALL OTHER PERSONS OR ENTITIES, FROM ANY AND ALL LIABILITY, CLAIM, DAMAGE, LOSS, COST OR EXPENSE, ARISING DIRECTLY OR INDIRECTLY FROM MY PARTICIPATION IN BIKE SURGEON EVENTS AND/OR USE OF A DEMONSTRATION BICYCLE.
    I Agree
  8. I acknowledge that I am signing this document voluntarily and without duress or coercion.
    I Agree

I expressly agree that the forgoing agreement shall be construed to provide the parties being released with the broadest relief possible. If any portion is held invalid, the balance shall continue in full legal force and effect. This agreement shall be governed by the laws of the State of Illinois, and any litigation between the parties shall be filed in the Municipal or Circuit Court of the County of St. Clair, State of Illinois.

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

Last Name*
Tenth Participant's Date of Birth*
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*

Phone*
Parent or Guardian's Date of Birth*
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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