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AGREEMENT AND RELEASE FROM LIABILITY

1. Voluntary Participation:

I hereby request to ride a Pedego electric bicycle from Pedego of Moab.

2. Assumption of Risk:
I am aware that the activity will carry with it inherent risks that cannot be eliminated regardless of the level of care and precaution taken. Such risks will require my extra care and attention to detect and avoid. The risks of said activity will include but are not limited to, bruising, scrapes, scratches, sprains, broken bones and other injuries of possibly greater severity such as paralysis or death. I hereby accept and assume all such risks, and do so for any minors under my care, as indicated by my signature below.

3. Conduct of Rider:
I agree to ride the bicycle in compliance with all traffic laws, and will exercise care to ensure the safe operation of the bicycle. I agree not to perform stunts, or to attempt any “trick” riding during the test drive.

4. Release:
In consideration for being permitted by Pedego of Moab to rent and ride a Pedego electric bike, I hereby release Pedego of Moab from all actions, claims or demands which I may now or hereafter have, and I agree that I, my assignees, heirs, personal representatives and other agents will not make a claim against, or sue, or attach the property of Pedego of Moab on account of injury or other damage resulting during the ride or from the negligence or other acts (excluding gross negligence and intentional acts), however caused, of their employees, contractors, or other agents.

I hereby confirm that I have been given the opportunity to carefully read this agreement and release, and have done so and understand it, or I have voluntarily elected to not read it. I am aware this is a release of liability, and hereby sign it of my own free will.

Today's Date: April 25, 2024 

First Participant's Name

First Name*

Middle Name

Last Name*
First Participant's Age Acknowledgment*
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*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
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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.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*
Parent or Guardian's Age Acknowledgment*
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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