Loading...

Bicycle Coalition of Maine Activity and Ride Waiver and Release of Liability

In consideration of being permitted to participate in any way in the Bicycle Coalition of Maine Education Activity, Rides and any related events (collectively the “Event”) offered by the Bicycle Coalition of Maine and the organizing entity to the PARTICIPANT, for themselves, and their personal representatives, heirs, spouse, parents, siblings, and children, hereby acknowledges and agrees to the following:

 

1. ACKNOWLEDGEMENT OF RISK: I acknowledge, agree and represent that the lesson and/or tour and related activities (“Activities”) I am about to engage in voluntarily, bear certain known risks and unanticipated risks which could result in injury, death, illness or disease, physical or mental damage to myself, my property, or other third parties or their property, or the property of THE BICYCLE COALITION OF MAINE. I further acknowledge that I understand the nature of cycling and related Activities and that I am 18 years or older, qualified, in good health and proper physical condition to participate in such Activities and willingly agree to comply with the stated customary terms and conditions of participation.

 

2. ACCEPTANCE OF RISK AND RESPONSIBILITY: I fully understand that (a) cycling and electric bicycle riding, and related Activities involve risks and dangers of damage to personal property and serious bodily injury, including, but not limited to, permanent disability, paralysis, and death to myself and to other third parties; (b) these risks and dangers may be caused by my own actions or inactions, the actions or inactions of others participating in the Activities, the condition in which the Activities take place, or the negligence of the “Releases” named below; (c) there may be other risks and social and economic losses either known of unknown to me or not readily foreseeable at this time; and I agree, covenant and promise to accept and assume all responsibility and risk for injury, death, illness or disease, or damage to myself, my property, arising from my participation in the Activities.

 

3. I HEREBY RELEASE, DISCHARGE, AND COVENANT to accept and assume all responsibility and risk for injury, death, illness, disease, or damage to other third parties and their property arising from my participation in the Activities and agree not to sue THE BICYCLE COALITION OF MAINE, the Maine Department of Transportation, its instructors, employees, agents, owners, and contractors (each considered one of the “Releasees”) from all liability, claims, demands, losses, injuries, damage to property, or other damages on my account caused in whole or in part by the negligence of the “Releasees” or otherwise, including negligent rescue operations; and I further agree that if despite this release and Waiver of Liability, assumption of risk, and indemnity agreement, or anyone on my behalf, make a claim against anyone of the Releasees, I will indemnify, save and hold harmless each of the Releasees from any litigation, attorney fees, loss, liability, or cost which may incur as the result of such claim. I further understand and agree to fully reimburse THE BICYCLE COALITION OF MAINE for any damage caused to property of THE BICYCLE COALITION OF MAINE, as a result of my participation in the Activities. My participation in the Activities is purely voluntary, no one is forcing me to participate, and I elect to participate despite the risks.

 

4. I AGREE TO ABIDE by THE BICYCLE COALITION OF MAINE’s policies and agree to comply with all instructions of the guide, instructor, staff in connection with participation in the Activity, and failure to follow such directions shall be grounds for termination of my privilege to participate in the Activities without reimbursement or cancelation of fees paid or owed. I understand that the use or possession of drugs or alcohol is strictly prohibited before and during the Activities and will be grounds for immediate removal from the Activities. I agree that if in the judgment of my instructor and/or guide, he/she must call for assistance during the trip due to my noncompliance with his/her instructions or THE BICYCLE COALITION OF MAINE’s policies that I accept responsibility for paying and associated rescue and transportation costs.

 

5. By participating in or attending any Activities in connection with THE BICYCLE COALITION OF MAINE, I CONSENT TO THE USE OF ANY PHOTOGRAPHS, PICTURES, FILM, OR VIDEOTAPE TAKEN OF ME or provided by me for publicity, promotion, television, websites, or any other use, and expressly waive any right of privacy, compensation, copyright or other ownership right connected to same.

 

6. I represent that without the permission of the organizer of the Event I will not transfer my right to participate in the Event to any other party, or encourage any other party to participate in the Event, unless registered with the organizer, and will hold harmless and indemnify the Released Parties from any liability of the Released Parties because this representation is found to be untrue.

 

ALL DISPUTES BETWEEN MYSELF AND ANY RELEASED PARTY ARISING FROM MY PARTICIPATION IN THE EVENT WILL BE GOVERNED BY THE LAWS OF THE STATE OF MAINE, AND THE EXCLUSIVE JURISDICTION THEREOF SHALL BE IN THE STATE COURTS OF THE STATE OF MAINE, AND THE VENUE FOR THESE DISPUTES SHALL BE IN CUMBERLAND COUNTY, MAINE.

 

IF ANY PART OF THIS AGREEMENT IS DETERMINED TO BE UNENFORCEABLE FOR ANY REASON OR UNDER ANY CIRCUMSTANCE, IT IS INTENDED THAT ALL OTHER TERMS WILL BE ENFORCED IN ALL OTHER CIRCUMSTANCES.

 

I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY AGREEING TO IT, AND DO SO FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE, OR GUARANTEE BEING MADE TO ME, AND I INTEND BY CHECKING BELOW I DO CONSTITUTE A COMPLETE AND UNCONDITIONAL RELEASE OF LIABILITY TO THE GREATEST EXTENT ALLOWED BY THE LAWS OF THE STATE OF MAINE.

 

I HAVE NOT RELIED ON THE ADVICE OR INPUT OF ANY RELEASED PARTY ABOUT THE INTERPRETATION OR EFFECT OF THIS AGREEMENT, AND FURTHER ACKNOWLEDGE THAT NO RELEASED PARTY HAS THE AUTHORITY TO MAKE ANY REPRESENTATIONS CONCERNING THE INTERPRETATION OR EFFECT OF THIS AGREEMENT, OR TO VERBALLY LIMIT OR MODIFY ANY TERM OF THIS AGREEMENT.


First  Name
First Name*
Last Name*
Phone*
First  Age Acknowledgment*
First  Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
First  Signature*
Second Name
First Name*
Last Name*
Date of Birth*
Date of Birth
Third Name
First Name*
Last Name*
Date of Birth*
Date of Birth
Fourth Name
First Name*
Last Name*
Date of Birth*
Date of Birth
Fifth Name
First Name*
Last Name*
Date of Birth*
Date of Birth
Sixth Name
First Name*
Last Name*
Date of Birth*
Date of Birth
Seventh Name
First Name*
Last Name*
Date of Birth*
Date of Birth
Eighth Name
First Name*
Last Name*
Date of Birth*
Date of Birth
Ninth Name
First Name*
Last Name*
Date of Birth*
Date of Birth
Tenth Name
First Name*
Last Name*
Date of Birth*
Date of Birth
Parent or Guardian's Email Address
Email
Check to receive information, news, and discounts by e-mail.
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
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*
Last Name*
Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
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!