RELEASE AND WAIVER OF LIABILITY,
ASSUMPTION OF RISK, INDEMNITY AGREEMENT
IN CONSIDERATION of being permitted to participate in any way in Mill Race Cyclery sponsored
Bicycling Activities ("Activity") for myself my personal representatives, assigns, heirs and next of
1. ACKNOWLEDGE, agree and represent that I understand the nature of Bicycling Activities and
that I am qualified to participate in such Activity. I fully acknowledge that the Activity will be
conducted over public roads, bike trails, and facilities open to the public during the Activity and upon which the
hazards of traveling are to be expected. I fully agree and represent that if at any time I believe
conditions to be unsafe, I will immediately discontinue further participation in this activity.
2. FULLY UNDERSTAND that (a) BICYCLING ACTIVITIES INVOLVES RISKS AND
DANGERS OF SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY ,
PARALYSIS AND DEATH ('Risks"); (b) these Risks and dangers may be caused by my own actions,
or inactions, the actions or inactions of others participating in the Activity, the conditions in which the
Activity takes place, or THE NEGLIGENCE OF THE "RELEASES" NAMED BELOW; (c) there
may be OTHER RISKS AND SOCIAL ECONOMIC LOSSES either not known to me or not readily
foreseeable at this time; and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL
FOR LOSSES, COSTS, AND DAMAGES I incur as a result of my participation in the Activity.
3.HEREBY RELEASE DISCHARGE, COVENANT NOT TO SUE, AND AGREE TO INDEMNIFY
AND SAVE AND HOLD HARMLESS Mill Race Cyclery, their representatives, directors, agents and
employees, other participants, any sponsors, advertisers, and if applicable, CLAIMS, DEMANDS,
LOSSES, OR DAMAGES ON MY ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN
WHOLE OR PART BY THE NEGLIGENCE OF THE "RELEASES" OR OTHERWISE,
INCLUDING NEGLIGENT RESCUE OPERATIONS.
I HAVE READ THIS AGREEMENT, FULLY UNDERSTANDING ITS TERMS, UNDERSTAND
THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND I HAVE SIGNED IT
FREELY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE AND
INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO
THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF
THIS AGREEMENT IS HELD TO BE INVALID THE BALANCE, NOTWITHSTANDING,
SHALL CONTINUE IN FULL FORCE AND AFFECT.
4. All participants are required to wear a helmet during the ride.
Telephone #: _____________________________
Email Address: _____________________________
Emergency Contact: ______________________________ Phone #: ____________________