WAIVER, RELEASE AND INDEMNITY

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Please fill out the required form parts and sign by writing your name in the appropriate fields.

Email *

Record my email address with my response

Date of Birth
*

YYYY

Name *

Age *

Disclaimer *

I understand and agree that my participation in events, programs, races or activities organized, operated, conducted and/or sanctioned by the King Street Cycles Ride Club is conditional upon my execution of this document.

1) I am aware that cycling, and in particular competitive cycling, endurance and BMX racing, involves the possibility of injury or death.

2) I accept these risks, and all others arising from these events and programs, even if arising from the negligence, gross negligence, or negligent rescue by those associated in any way with the King Street Cycles Ride Club events and programs I may be involved in, the venues at which these events and programs take place or by those organizing, officiating, or participating in these events and programs throughout the year, including their respective officers, directors, employees, agents, servants, volunteers and representatives (the "Releasees").

3) I understand that all applicable rules for participation must be followed and that the SOLE RESPONSIBILITY FOR MY PERSONAL SAFETY REMAINS WITH ME, including my physical and emotional preparation and fitness to participate in all events and programs throughout the year.

4) I understand and agree to remove myself from participation if I sense or observe any unusual hazard or unsafe condition, or if, at any time, at any program, I feel unable or unfit to safely continue for any reason.

5) I give, a FULL RELEASE AND WAIVER OF LIABILITY AND ALL CLAIMS that I have, or may have in the future, against the King Street Cycles Ride Club, and all other Releasees from all liability for any loss, damage, injury or expense that I may Suffer as a result of my participation in any part or parts of the events or programs or my presence at any venue at which they may take place, due to any cause whatsoever including the forms of negligence set forth in paragraph 2 above or from any breach of contract or statutory duty or other duty of care including any duty of care owed under the relevant Occupiers Liability Act, on the part of the releasees.

6) I AGREE NOT TO SUE and I further agree TO INDEMNIFY AND SAVE HARMLESS the Releasees from all expenses, fees, liability or damage award or cost of any type whatsoever arising from my participation in these events or programs.

I HAVE READ AND UNDERSTOOD THIS WAIVER, RELEASE AND INDEMNITY. I am aware that by signing this agreement I am waiving substantial legal rights (on my behalf and on the behalf of my heirs, executors, administrators and next of kin), including the giving up of my

PARENTAL CONSENT FOR MINOR PARTICIPATION AND INDEMNITY AGREEMENT
*

I have read and understood the above waiver, release and indemnity, and have discussed the same with the minor person signing above. I am satisfied the said minor understands the waiver and release and his/her obligations as set out. In consideration of the participation of my minor child/ward I too agree to waive, release and indemnify the Releasees in the terms set out above.

I am aware that by signing this agreement I am waiving substantial legal rights, which my minor child/ward and I, our respective heirs, executors, administrators and next of kin may have against the Releasees.

(confirm by writing your name)

Date

YYYY

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