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• THIS WAIVER WILL EXPIRE AT 11:59 PM ON DECEMBER 31 OF THE CURRENT YEAR IT WAS SIGNED.

• ALL RIDERS ARE REQUIRED TO WEAR HELMETS AT ALL TIMES WHEN RIDING.

• ALL RIDERS RIDE AT THEIR OWN RISK. NEITHER THE R5CICLISMO CYCLING CLUB, THE CLUB, ITS MEMBERS, DIRECTORS, SPONSORS, OFFICIALS, AND ATTORNEYS ASSUME ANY LIABILITY TO THE CLUB OR ANY RIDERS RIDING AS MEMBERS OR GUESTS. I understand that this R5CICLISMO Ride involves riding as part of a group on public streets where hazards exist. I acknowledge that cycling is an inherently dangerous sport and fully realize the dangers of participating in a group bicycle ride and FULLY ASSUME THE RISKS ASSOCIATED WITH SUCH PARTICIPATION INCLUDING, by way of example, and without limitation to the following: the dangers of collision with pedestrians, vehicles, other riders, and fixed or moving objects; the dangers arising from surface hazards, equipment failure, inadequate safety equipment, R5CICLISMO’S OWN NEGLIGENCE, and weather conditions; and the possibility of serious physical and/or mental trauma, injury, or death associated with cycling. THUS, ALL CLUB MEMBERS AND GUESTS ASSUME THEIR OWN RISK WHEN RIDING WITH R5CICLISMO. IT IS RECOMMENDED THAT ALL RIDERS HAVE SOME FORM OF MEDICAL INSURANCE BEFORE RIDING WITH THE CLUB. THE CLUB DOES NOT PROVIDE ANY MEDICAL OR ACCIDENT INSURANCE TO ITS MEMBERS OR GUESTS.

THIS IS A LEGAL DOCUMENT. READ IT CAREFULLY. BY SIGNING THIS FORM, YOU WILL ALSO BE GIVING UP ANY LEGAL RIGHT YOU MAY HAVE TO BRING A LAWSUIT AGAINST R5CICLISMO, ITS SPONSORS, MEMBERS, GUESTS, OFFICERS, DIRECTORS, ATTORNEYS, EMPLOYEES, AND MANAGERS.

YOUR SIGNATURE ALSO ACKNOWLEDGES THAT YOU ARE SIGNING THIS DOCUMENT VOLUNTARILY AND OF YOUR OWN FREE WILL AND NOT UNDER COERCION OR DURESS.

I ACKNOWLEDGE THAT CYCLING IS AN INHERENTLY DANGEROUS SPORT WHERE SERIOUS INJURY AND DEATH CAN AND DOES OCCUR.

I understand and agree that I will participate in all Club activities at my own risk. I further understand and agree that the Club is a community organization that provides cycling activities for its members and for the advancement of the sport, which will be a direct benefit to me.

I understand this is a non-competitive event and that racing is not allowed. I will obey the California Vehicle Code while on the ride, if I am ticketed by Law Enforcement for failing to obey the rules of the road that will not be cause to bring suit to R5CICLISMO

Therefore, on behalf of myself, my heirs, successors and assigns, and personal representatives, I HEREBY WAIVE, RELEASE, HOLD HARMLESS, DISCHARGE, INDEMNIFY AND PROMISE NOT TO SUE R5CICLISMO. d/b/a R5CICLISMO, of its sponsors, members, guests, directors, officers, attorneys and employees (collectively the “Released Parties”) from any and all rights and claims including those arising from the Released Parties’ own negligence, which I have or which I may hereafter accrue from any and all damages sustained by me of any kind directly or indirectly in connection with, or arising out of, my participation in any races, training/club rides or other activities run, sponsored, promoted or encouraged by the Club or travel to or return from such activities. I represent that, based upon a recent physical examination by a licensed medical provider, to the best of my knowledge I have no medical or physical condition that would affect my ability to participate in bicycle riding or any Club event or that my participation would endanger my health. I acknowledge that I have been advised to read this entire document carefully and that it has legal consequences. I represent that I have read the document carefully and that I am knowingly and voluntarily signing this waiver.

For internal and external use, R5CICLISMO may obtain, compile, and use contact information, photographs and audiovisual recordings of me. I consent to such uses and hereby waive all rights to approval and compensation.

I agree to use an electronic signature and that any physical or electronic copy of this Agreement, and its attachments can be used as if it was an original.

I am an adult of the age of majority in California. I agree to the terms and conditions hereof shall apply to all of my participation in the Activities, regardless of the year in which such participation takes place unless superseded by a new Agreement.

I ACKNOWLEDGE AND AGREE THAT THIS AGREEMENT IS INTENDED TO BE AS BROAD AND INCLUSIVE AS PERMITTED BY THE LAWS OF THE STATE OF CALIFORNIA AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS DEEMED TO BE INVALID, THE REMAINDER WILL CONTINUE IN FULL LEGAL FORCE AND EFFECT.

December 21, 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*
Participant's Phone Number

Participant's phone number
Parent or Guardian's Email Address

Email
Check to receive information, news on R5CICLISMO Cycling Club
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
Emergency Contact

Emergency Contact Name

Emergency Contact's Phone Number

PARENT GUARDIAN WAIVER FOR MINORS (Under 18 years old)

The undersigned parent and natural guardian or legal guardian does hereby represent that he/she is, in fact, acting in such capacity and agrees to save and hold harmless and indemnify each and all of the parties referred to above from all liability, loss, cost, claim or damage whatsoever which may be imposed upon said parties because of any defect in or lack of such capacity to so act and release said parties on behalf of the minor and the parents or legal guardian.

Date PARENT/GUARDIAN Printed Name Legal Signature Minor's Name (use additional form for each)

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.

I HAVE READ THIS AGREEMENT



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*

Phone*
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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