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WAIVER AND RELEASE OF LIABILITY -- READ BEFORE SIGNING

In consideration of being allowed to participate in any way in the Schwab Innovative Fitness program, its related events and activities, I,  the undersigned, acknowledge, appreciate, and agree that:

1. The risk of injury from the activities involved in this program is significant, including the potentialfor permanent paralysis and death, and while particular skills, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and,

2. I KNOWINGLYAND FREELYASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,

3. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the Company immediately; and,

4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS Schwab Innovative Fitness their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used for the activity ("Releasees"), WITH RESPECT TO ANYAND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property associated with my presence or participation, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

 

I, the undersigned, intending to be legally bound, understand and agree that I am voluntarily

participating in Cure Chaser Cycling training rides, at my own request and at my own risk. I acknowledge that I am aware of all the inherent risks in these events, the risks of riding a bicycle on public roads and certify that I am physically fit, have not been otherwise informed by my physician and know of no restriction, disease or condition that would in any way present a risk to my health or prevent me from actively participating in this event.

In consideration of being permitted to participate in Cure Chaser Cycling training rides, I assume full responsibility for any injury or loss that may occur in connection with my participation, and I, on behalf of myself, my successors in interest, heirs, assigns, ad representatives hereby fully release and agree to hold

harmless Cure Chasers Cycling, its employees, officers, directors, and agents from any and all liability, claims, rights, or actions for death, bodily injury, property damage, or any other loss or inconvenience whatsoever, suffered by me or caused by me, at any time hereafter occurring as a result of my voluntary participation in Cure Chaser Cycling training rides.

I agree that I will be at least 13 years old to participate. If I am between the ages of 13 – 17, my parents and

I understand that a parent or legal guardian must accompany me at all times and must co‐sign below.

I declare my consent to be irrevocable and release Cure Chasers Cycling from any and all claims whatsoever in connection with the use of my name or photographs as previously described.

MUST BE SIGNED BY LEGAL GUARDIAN IF PARTICIPANT IS UNDER THE AGE OF 18 ON THE DATE THIS

AGREEMENT AND RELEASE IS EXECUTED.

The undersigned certifies that he/she is the parent or legal guardian of the participant, and as such and on behalf of the participants and myself, agrees to the terms of this agreement and holds harmless Cure Chasers Cycling for all liabilities. In addition, you the parent or legal guardian agrees to accompany the above mentioned on the course of any Cure Chasers Cycling rides at all times.

 

Are you currently under a physician's care or do you suffer from any of the following (required) :
  •  Type 1 Diabetes
  •  Type 2 DIabetes
  •  Diabetes other
  •  Asthma
  •  Hypertension
  •  Heart Disease
  •  Other
  •  No
If you answered yes to any of the above, please give any details that a ride leader needs to be aware of. I.E. I need an inhaler, I carry sugar products to treat low glucose :
Please fill in your name (required) :
 
Phone number (required) :
Emergency Contact (required) :
 
Emergency contact phone number (required) :
Your age (required) :
Are you signing this waiver for a Minor - if yes fill in name, age and sign below (required) :
  •  Yes
  •  No
Name of Minor participant :
 
Minor participant's age :
 I understand that by signing below, I am agreeing to both above waivers including Schwab Fitness & Cure Chasers Cycling & that I am agreeing to use of any photos taken at Cure Chaser events to be used on Cure Chaser promotional media materials including web based and print. (required)
Your signature (required) :
Where did you hear about us? :
  •  Meet Up.com
  •  store visit
  •  Friends
  •  USA Cycling
  •  USA Triathlon
  •  Cure Chaser Cycling Website
  •  Schwab Fitness Website
  •  Other
phone number :
I would like to receive Indiana Cure Chaser email/information for the following - Choose all that apply :
  •  JDRF Destination Rides
  •  How to Join the Indiana Cure Chaser State Team
  •  Weekly emails from the coach for training rides, events and the like
  •  TNT Destination Rides
  •  Send it all!!