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2009 Event Release

2010 USA Cycling Competitive and Non-Competitive Event Release Form
The following event release form has been approved by USA Cycling, Inc. If the above event, I hereby freely agree to and make the following substances prohibited by Releasees’ rules would make me sub-
reproduced, it must be in a minimum of 10 point type and retain the exact same contractual representations and agreements. I ACKNOWL- ject to penalties including, but not limited to, disqualification and
formatting.
EDGE THAT CYCLING IS AN INHERENTLY DANGEROUS suspension. I agree to be subject to drug testing if selected, and
SPORT AND FULLY REALIZE THE DANGERS OF PARTICI- its penalties if I fail to comply with the testing or am found posi-
PLEASE COMPLETE THE FOLLOWING INFORMATION
PATING IN THIS EVENT, whether as a rider, official, coach, tive for the use of a banned substance.
mechanic, volunteer, or otherwise, and FULLY ASSUME THE
I agree, for myself and my Successors, that the above repre-
TODAY’S DATE ____________________________________ RISKS ASSOCIATED WITH SUCH PARTICIPATION INCLUD- sentations are contractually binding, and are not mere recitals,
ING, by way of example, and not limitation: dangers associat- and that should I or my Successors assert a claim contrary to
EVENT NAME _____________________________________
ed with man made and natural jumps; the dangers of collision what I have agreed to in this contract, the claiming party shall be
EVENT DATE(S) ___________________________________
with pedestrians, vehicles, other riders, and fixed or moving liable for the expenses (including legal fees) incurred by the
objects; the dangers arising from surface hazards, including pot Releasees in defending the claims. This contract may not be
RACE(S)/ACTIVITY(IES) ENTERED____________________
holes, equipment failure, inadequate safety equipment, use of modified orally, and a waiver or modification of any provision
CLUB/TEAM NAME _________________________________ equipment or materials provided by the event organizer and oth- shall not be construed as a waiver or modification of any other
ers, THE RELEASEES’ OWN NEGLIGENCE, the negligence of provision herein or as a consent to any subsequent waiver or
ANNUAL LICENSE # ________________________________ others and weather conditions; and the possibility of serious modification. I consent to the release by any third party to
RACING AGE (as of December 31, 2010) ________________ physical and/or mental trauma or injury, or death associated with Releasees and their insurance carriers of my name and medical
NAME____________________________________________
the event. For myself, my heirs, executors, administrators, legal information that may relate solely to any injury or death I may
representatives, assignees, and successors in interest (collec- suffer arising from the event. Every term and provision of this
ADDRESS_________________________________________ tively “Successors”) I HEREBY WAIVE, RELEASE, DIS- contract is intended to be severable. If any one or more of them
CITY ______________________ ST _______ZIP__________ CHARGE, HOLD HARMLESS, AND PROMISE TO INDEMNI- is found to be unenforceable or invalid, that shall not affect the
FY AND NOT TO SUE the Releasees and all sponsors, organ- other terms and provisions, which shall remain binding and
PHONE____________________ E-MAIL ________________ izers and promoting organizations, property owners, law enforceable.
EMERGENCY CONTACT_____________________________ enforcement agencies, public entities, special districts and
properties that are in any manner connected with this event, and
EMERGENCY CONTACT PHONE______________________ their respective agents, officials, and employees through or by _______________________________________ ________
which the event will be held, (the foregoing are also collectively
Signature of Entrant
AGE
deemed to be Releasees), FROM ANY AND ALL RIGHTS AND
I ACKNOWLEDGE THAT BY SIGNING THIS DOCUMENT, I CLAIMS INCLUDING CLAIMS ARISING FROM THE
CONSENT AND RELEASE OF PARENT OR GUARDIAN
AM ASSUMING RISKS, AND AGREEING TO INDEMNIFY, RELEASEES’ OWN NEGLIGENCE TO THE MAXIMUM
NOT TO SUE AND RELEASE FROM LIABILITY THE ORGAN- EXTENT PERMITTED BY LAW, which I have or which may I am the parent or guardian of __________________(Child). My
IZER OF THIS EVENT AND USA CYCLING, INC. (USAC), ITS hereafter accrue to me and from any and all damages which Child is fit for the event, and I consent to my Child’s participation.
ASSOCIATIONS (THE UNITED STATES CYCLING FEDERA- may be sustained by me directly or indirectly in connection with, I HAVE READ AND I UNDERSTAND THE ABOVE CON-
TION (USCF), NATIONAL OFF ROAD BICYCLE ASSOCIA- or arising out of, my participation in or association with the event, TRACT. In consideration of allowing my Child to participate, I
TION (NORBA), NATIONAL COLLEGIATE CYCLING ASSOCI- or travel to or return from the event. I agree it is my sole respon- consent to the contract and agree that ITS TERMS SHALL
ATION (NCCA), U.S. PROFESSIONAL RACING ASSOCIA- sibility to be familiar with the event course and agenda, the LIKEWISE BIND ME, MY CHILD, and our heirs, legal represen-
TION (USPRO), AND BMX ASSOCIATION (BMXA)), AND USA Releasees’ rules, and any special regulations for the event and tatives, and assignees. I HEREBY RELEASE AND SHALL
CYCLING DEVELOPMENT FOUNDATION (USACDF), AND agree to comply with all such rules and regulations. I under- DEFEND, INDEMNIFY AND HOLD HARMLESS THE
THEIR RESPECTIVE AGENTS, EMPLOYEES, VOLUN- stand and agree that situations may arise during the event which RELEASEES FROM EVERY CLAIM AND ANY LIABILITY that
TEERS, MEMBERS, CLUBS, SPONSORS, PROMOTERS may be beyond the control of the Releasees, and I must contin- I or my Child may allege against the Releasees (including rea-
AND AFFILIATES (COLLECTIVELY “RELEASEES”), AND ually ride and otherwise participate so as to neither endanger sonable legal fees and costs) as a direct or indirect result of
THAT I AM GIVING UP SUBSTANTIAL LEGAL RIGHTS. THIS myself nor others. I accept responsibility for the condition and injury or death to me or my Child because of my Child’s partici-
RELEASE IS A CONTRACT WITH LEGAL AND BINDING adequacy of my equipment, any equipment provided for my use, pation in the event, WHETHER CAUSED BY THE NEGLI-
CONSEQUENCES AND IT APPLIES TO ALL RACES AND and my conduct in connection with this event. I will wear a hel- GENCE OF THE RELEASEES OR OTHERS TO THE MAXI-
ACTIVITIES ENTERED AT THE EVENT, REGARDLESS met which satisfies the requirements of the Releasees’ Racing MUM EXTENT PERMITTED BY LAW. I PROMISE NOT TO
WHETHER OR NOT LISTED ABOVE. I HAVE READ IT CARE- Rules or Regulations and that can protect against serious head SUE RELEASEES on my behalf or on behalf of my Child regard-
FULLY BEFORE SIGNING, AND I UNDERSTAND WHAT IT injury, and assume all responsibility and liability for the selection ing any claim arising from my Child’s participation in the event.
MEANS AND WHAT I AM AGREEING TO BY SIGNING.
of such a helmet. I have no physical or medical condition which
would endanger myself or others if I participate in this event, or
In consideration of the issuance of a license to me by one or would interfere with my ability to safely participate in this event. _________________________________________________
more Releasees or the acceptance of my application for entry in I understand that drug testing may be conducted for athletes
Signature of Parent or Guardian
registered for this event and that the use of blood boosting or M:2010 Membership Forms/2010 Event Release.qxp Rev 01/10