Loading...

WAIVER AND RELEASE AGREEMENT

This Waiver and Release Agreement (the “Agreement”) is a legally binding Agreement by and between the

 

Blended Pedaler (hereinafter “OWNER”) and the undersigned Participant as stated below:

Participant acknowledges that certain inherent risks and dangers may arise during outdoor activities, including but not limited to the operation of vehicles such as bicycles and e-bikes (collectively the “Outdoor Activities”). Participant acknowledges that these risks may cause or result in injury to person or property and possibly disfigurement or death during participation in the Outdoor Activities. At no time does the OWNER require a Participant to participate in Outdoor Activities, and Participant acknowledges and agrees that Participant’s participation in these Outdoor Activities is voluntary and undertaken by Participant at his/her election. If at any time a Participant is uncomfortable in participating in the Outdoor Activities, Participant may elect to not participate in such activity.

Participant assumes all risks and responsibilities for injury related in any way to participation in any Outdoor Activity. As a condition of participation in Outdoor Activities, Participant forever releases and discharges OWNER and their employees, volunteers, family members, associates, representatives and agents (collectively the “Released Parties”), from any and all liability, claims or causes of action, in both equity or at law, for injury to person or property that may arise from participation or attendance at any Outdoor Activity, including but not limited to claims arising from ordinary negligence, gross negligence, intentional acts, mistake, act, failure to act, omission, failure to supervise or any other claim of any type or nature. Furthermore, Participant agrees to hold harmless and indemnify OWNER together with their employees, volunteers, family members, associates, representatives and agents, (collectively the “Indemnified Parties”), from any and all losses, claims, actions, lawsuits, costs or expenses including but not limited to damage to property, medical expenses, liens, judgments, court costs and all attorney’s fees arising from any injury to person or property (including disfigurement or death) asserted by Participant arising out of or in connection with any Outdoor Activity, including but not limited to claims arising acts by either OWNER, the Indemnified Parties, the Released Parties, or Participant from ordinary negligence, gross negligence, intentional acts, mistake, act, failure to act, omission, failure to supervise or any other claim of any type or nature.

Participant agrees and acknowledges that OWNER may retain Participant’s credit card information or other source of funding for purposes of reimbursement for loss or damage to OWNER’s property. In addition, Participant agrees and acknowledges that OWNER may collect a reasonable fee for processing these charges, as well as repair to or replacement of the property.

This Agreement shall be binding upon the Participant as well as the Participant’s heirs, executors, administrators, personal representatives and assigns. If any portion of this Agreement is deemed, by a court of competent jurisdiction, to be void or unenforceable, the remaining provisions shall be enforced to the full extent allowed as if the particular void or unenforceable provisions were not herein contained.

If the Participant is under eighteen (18) years of age, Participant’s parent(s) execution of this Agreement constitutes his/her/their consent to be bound by the terms of the same, including the release, hold harmless and indemnification provisions.

WARNING: THIS WAIVER AND RELEASE ACTS AS A RELEASE OF YOUR RIGHTS. BY EXECUTION OF THIS AGREEMENT, YOU ARE AFFIRMING THAT YOU HAVE READ THIS DOCUMENT AND AGREE TO THE CONDITIONS STATED HEREIN. IF YOU DO NOT UNDERSTAND THIS AGREEMENT, YOU MAY WISH TO CONSULT AN ATTORNEY OF YOUR CHOICE.

 

Rules of Enjoyment: 

Must wear a helmet at ALL times  * Do NOT leave bike unattended * E-Bikes are NOT allowed on sidewalks * Use hand signals when turning on a public road * Do not use throtlle for full ride, must alternate and use the pedal assist option or as a regular bike. Using the throttle assist option will drain the battery quickly and will shorten your enjoyment time. * Must abide by all state and local laws i.e crosswalk, stop signs, yield signs, etc. 

 

 

Date: June 25, 2022

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 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*
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*
Check to receive discounts by e-mail.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Parent or Guardian's Driver's License / ID Card

Driver's License / ID Card Number*

Issuing State*
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*
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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!