online-application – Florida Tandem Club

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Stoker: *

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IN CONSIDERATION OF PANTHERS TANDEM CLUB, INC. PERMITTING ME OR MY MINOR CHILD TO PARTICIPATE IN THESE RIDES OR ACTIVITIES, I, THE UNDERSIGNED, FOR MYSELF AND MY HEIRS, NEXT OF KIN, ASSIGNS, AND PERSONAL REPRESENTA5TIVES, DO HEREBY AGREE TO THE FOLLOWING: 1 Acknowledge, agree and represent that I understand the nature of Bicycling Activities and that I am qualified in good health, and in proper physical condition to participate in such activity. I further acknowledge that the activity will be conducted over public roads and facilities open to the public during the activity and upon which the hazards of traveling are to be expected. I further agree and warrant that if at any time I believe conditions to be unsafe; I will immediately discontinue further participation in the activity. 2 Fully understand that (a) Bicycling activities involve risks and dangers of serious bodily injury, including viral infections, bacterial infections and other communicable diseases and illnesses, including permanent disability, paralysis and death (Risks): (b) these risks and dangers may be caused by my own actions, or inactions, the action 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 or economical losses either not know to me or not readily foreseeable at this time and I fully accept and assume all risks and all responsibility for all losses, cost 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 PANTHERS TANDEM CLUB, INC., the LAB, their respective administrators, directors, agents, officers, members, volunteers, and employees, other participants, any sponsors, advertisers, and if applicable, owners and leases or premises in which the activity takes place, (each considered to be one of the “Releases” herein) from all liability, claims, demands, losses or damages on my account caused or alleged to be caused in whole or in part by the negligence of the “Releases” or otherwise, including negligent rescue operations. I further agree that if, in spite of this release and waiver of liability, assumption of risk, and indemnity agreement I or anyone on my behalf, makes a claim against any of the Releasees, I will indemnify, save, and hold harmless each of the releases from any litigation expense, attorney fees, loss, liability, damage, or cost of which any may incur as the result of such claim. I am 18 years of age or older, have read and understand the terms of this agreement, understand that I am giving up substantial rights by signing this agreement, have signed it voluntarily and without an inducement of assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allow by law. I agree that if any portion of this agreement is held to be invalid, the balance, nothwithstanding, shall continue in full force and effect.

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