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Salt Lake eBikes Rental Waiver

WARNING: There are significant elements of risk in any adventure, sport or activity associated with pedal driven cycles. electric assist cycles or throttle activated electric bicycles including but not limited to: bicycles (referred to herein as “activity”) and the use of any equipment. It is up to you to master the basics - moving, maneuvering, shifting gears, braking and turning-before beginning your activity, to obey all traffic laws and/or regulations and to yield to pedestrians. Otherwise you pose a danger to yourself and to others.

ACKNOWLEDGEMENT OF RISKS: I understand that there are inherent risks in this type of activity. These risks may result in serious injury or death, and include but are not limited to the following: 1) Falls; 2) Collisions with pedestrians, cycles, cycle riders, vehicles, manmade and natural objects; 3) Hazards of trails, routes or roadways including even or unstable surfaces, steep grades, sharp turn, and or; 4) the presence of water, sand, gravel, mud, oil and debris which may inhibit my ability to maneuver or stop; 5) Cold weather and heat related injuries or illnesses including hypothermia, frosting, frostbite, heat exhaustion, heat stroke and dehydration; 6) Inclement weather, fog banks which can reduce visibility to near zero, varied or severe wind, weather or physical coordination, ability to balance or control a bicycle, the speed at which I travel and my ability to follow directions; 9) Equipment failure including tire puncture and problems in shifting and or braking; 10) Loss of or damage to personal property; 11) Fatigue, chill and or dizziness, which may diminish my reaction time and increase the risk of an accident; 12) Accidents or illnesses occurring in remote places where there are no available medical facilities. I understand the description of these risks is not complete and that unknown or unanticipated risks may result in injury, illness or death. I understand the use of alcohol or drugs may impair my abilities.

EXPRESS ASSUMPTION OF RISK AND RESPONSIBILITY: I agree to assume responsibility for those risks identified herein and those not specifically identified. I certify that I am physically and mentally capable of participating in this activity. My participation in this activity is purely voluntary. No one is forcing me to participate. I elect to participate in spite of the risks. Therefore, I assume full responsibility for myself and/or any other minor children for whom I am responsible for. I understand that unknown circumstances may occur, such as bodily injury, accidents, illness, death, loss of personal property, and any other related instances. Head injuries pose a serious risk to bikes. I understand the benefit of wearing approved helmet and body gear while cycling.

COVENANT OF GOOD FAITH: I recognize that you, as provider of these services, will operate under a covenant of good faith and fair dealings, and that you may find it necessary to terminate an activity due to forces of nature, medical necessities or problems in the group, and or refuse or terminate, the participation of any person you judge to be incapable of meeting the rigors or requirements in this activity. I accept your right to take such actions for the safety of myself and or other participants. I acknowledge that no guarantees have been made with respect to cycling objectives.

AUTHORIZATION: I hereby authorize any medical treatment deemed necessary in the event of any injury while participating in the activity. I either have appropriate insurance or in its absence agree to pay all costs of rescue and/or medical services as may be incurred on my/our behalf. I agree that any film or photographs of me, as the participant, become your property and may be used for promotional or commercial purposes.

RELEASE: In consideration of services of property provided, I, for myself and any minor children for which I am parent, legal guardian or otherwise responsible, any heirs, personal representative or assigns, do hereby release Salt Lake eBikes LLC, its principals, directors, officers, agents, employees and volunteers, and each and every land owner, the City of Salt Lake, municipal and/or governmental agencies upon whose property an activity is conducted, from all liability and waive any claim for damage arising from any cause whatsoever (except that which is the result of gross negligence).

SECURITY DEPOSIT: To cover the value of the bicycle rental, Salt Lake eBikes LLC will place a temporary hold on your credit card for the value of the bicycle that is being rented. When the bicycle is returned, we will remove the hold. Please note, we are not taking the amount of the bicycle from your account; this is just an authorization to take the funds if the bicycle is not returned in the original, undamaged condition. If the bicycle is damaged upon return, we reserve the right to charge the customer the cost to repair the bicycle or replace the bicycle. All renters are responsible for returning a bicycle and or equipment in clean and original condition. If any excessive sand, dirt, or mud is built up on any bicycle or equipment an additional $40 will be charged per bicycle(s) and $10 per equipment.

RENTAL PICK-UP AGREEMENT: During high volume days, the rental customer will have 1/2 hour from your reservation time to claim your rental. If you do not pick-up your rental within 1/2 hour of your reservation time, Salt Lake eBikes LLC reserves the right to rent the bicycle to another customer.

HELMET WAIVER & BICYCLE/EQUIPMENT AGREEMENT: I recognize the dangers inherent with cycling (bicycles, tandem bikes, electric bikes, ect.) activities. I wish to participate in cycling activities. I realize that I am subject to injury from this activity and that no form of planning can remove all the danger to which I am exposing myself. I have been offered a protective safety helmet, which can help prevent head injury and or permanent brain damage in the event of an accident. Against the advice of both you and the insurance underwriters I am refusing this critical safety precaution.  I am assuming all hazards of risk upon myself. Upon signing this form I am fully responsible for any and all damages left on the bicycle(s) and equipment, including, but not limited to the following: Tires, tubes, wheels, brakes, helmets, locks, and all other equipment the belongs to Salt Lake eBikes LLC.

Date: August 16, 2022

First Rider's Name

First Name*

Last Name*

Phone*
First Rider's Date of Birth*
I certify that I am 18 years of age or older
First Rider's Information

Height of Rider: (feet/inches) *
First Rider's Signature*
Second Rider's Name

First Name*

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

Height of Rider: (feet/inches) *
Third Rider's Name

First Name*

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

Height of Rider: (feet/inches) *
Fourth Rider's Name

First Name*

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

Height of Rider: (feet/inches) *
Fifth Rider's Name

First Name*

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

Height of Rider: (feet/inches) *
Sixth Rider's Name

First Name*

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

Height of Rider: (feet/inches) *
Seventh Rider's Name

First Name*

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

Height of Rider: (feet/inches) *
Eighth Rider's Name

First Name*

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

Height of Rider: (feet/inches) *
Ninth Rider's Name

First Name*

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

Height of Rider: (feet/inches) *
Tenth Rider's Name

First Name*

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

Height of Rider: (feet/inches) *
Rider's 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
A signed copy of this waiver will be sent to the email address you provide.
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*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information

Height of Rider: (feet/inches) *
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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