Thanks for your membership in the Utah Velo Club.

Please complete the form below and click "SUBMIT WAIVER"

 

First Name:       

Last Name:         

Home Phone:   

e-mail address 

Comments:      

 

Participant Assumption of Risk

I acknowledge that cycling and snowshoeing are inherently dangerous sports and fully realize the dangers of participating in bicycle rides, bicycle races, and backcountry events.  I agree that it is my duty to exercise care for the protection of myself and others while participating in club/team events.   I represent that I am covered under my own insurance policies to cover any personal injuries to myself or which I may cause to others.  I acknowledge that by signing this document, I am assuming risks, and agreeing to indemnify, hold harmless, not to sue, and release from liability any other participant, ride leader, or sponsor of the Utah Velo Club.  I hereby wave all claims against the Utah Velo Club, Ride Leader, sponsors, and volunteers associated with the Utah Velo Club.  I hereby wave all demands and causes of action of every kind whatsoever for any damages or injuries which may result from participation in any Utah Velo Club event including group rides, races, and backcountry events.  I further attest that I am physically fit and prepared to participate in these events and that I will wear an approved helmet and protective clothing appropriate for the event.  I agree to be courteous motorists and pedestrians on the roads and trails during rides, races, and other events.  I will maintain vigilance by not using ear buds or any other device that impairs hearing while on the bike.  This covers all club events until the club is dissolved.

  I have read the foregoing Assumption of Risk and understand, agree, and accept personal responsibility.  Yes   No

  I am at least 18 years old.   YES NO

 Parent Permission with name and Address: