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SHORTHILLS CYCLING CLUB REGISTRATION
Adult Membership $40 | Youth (16&Under) $30 | family membership $80
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First Name
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Last Name
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Gender
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Email
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Date of Birth
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Street Address
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City
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ADDITIONAL FAMILY MEMBERS
(for family memberships only)
First Name
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Last Name
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Date of Birth
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First Name
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First Name
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Last Name
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Date of Birth
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Year
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Emergency Contact Name
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Emergency Contact Phone
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Club Forum Username
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Visit www.shorthillscyclingclub.com/forum
Occupation
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RELEASE OF LIABILITY, WAIVER OF CLAIMS, ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT
(hereinafter referred to as the “Release Agreement”)
BY SIGNING THIS DOCUMENT YOU WILL WAIVE OR GIVE UP CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE OR CLAIM COMPENSATION FOLLOWING AN ACCIDENT
PLEASE READ CAREFULLY!
I agree to the above
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Yes
Club Name:
ShortHills Cycling Club
and its (their) directors, officers, employees, instructors, guides, agents, representatives, independent contractors, subcontractors, suppliers, sponsors, successors and assigns (all of whom are hereinafter referred as “the Releasees”)
DEFINITION
In this Release Agreement: the term
"Mountain Biking"
shall include all activities, services and use of facilities either provided by or arranged by the Releasees, including, but not limited to: orientation and instruction sessions; recreational activities undertaken during the event, tour; travel by mountain bike; all travel either within or beyond the designated boundaries, including in the backcountry and on logging roads and trails.
I agree to the above
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Yes
ASSUMPTION OF RISKS
I am aware that Mountain Biking involves many inherent risks, dangers and hazards, including but not limited to: exposed rock, earth, ice or other natural objects; trees, tree wells, tree stumps, forest deadfall; holes and depressions on or beneath the trail or surface; variable and difficult weather conditions; changes or variations in the terrain which may create blind spots or areas of reduced visibility; streams and creeks; cliffs; crevasses; travel on back-country roads; snowcat roads, road-banks and cut-banks; impact or collision with other mountain bikes and vehicles, becoming lost or separated from the guides or other participants; mechanical failure of mountain bikes and related equipment; extreme and rapidly changing weather conditions; encounter with wildlife including bears; avalanches; the failure to operate a mountain bike safely or within one's own ability; negligence of other mountain bikers and other persons; AND NEGLIGENCE ON THE PART OF THE RELEASEES, INCLUDING THE FAILURE BY THE RELEASEES TO SAFEGUARD OR PROTECT ME FROM THE RISKS, DANGERS AND HAZARDS REFERRED TO ABOVE. Communication in the alpine terrain may be difficult, and in the event of an accident, rescue, medical treatment and evacuation may not be available or may be delayed. Alpine weather conditions may be extreme and can change rapidly and without warning.
I AM AWARE OF THE RISKS, DANGERS AND HAZARDS ASSOCIATED WITH MOUNTAIN BIKING AND I FREELY ACCEPT AND FULLY ASSUME ALL SUCH RISKS, DANGERS AND HAZARDS AND THE POSSIBILITY OF PERSONAL INJURY, DEATH, PROPERTY DAMAGE OR LOSS RESULTING THEREFROM.
I agree to the above
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Yes
RELEASE OF LIABILITY, WAIVER OF CLAIMS
AND INDEMNITY AGREEMENT
In consideration of the RELEASEES agreeing to my participation in mountain biking and permitting my use of their services, equipment and other facilities, and for other good and valuable consideration, the receipt and sufficiency of which is acknowledged, I hereby agree as follows:
1. TO WAIVE ANY AND ALL CLAIMS that I have or may in the future have against the RELEASEES AND TO RELEASE THE RELEASEES from any and all liability for any loss, damage, expense or injury, including death, that I may suffer or that my next of kin may suffer, as a result of my participation in mountain biking, DUE TO ANY CAUSE WHATSOEVER, INCLUDING NEGLIGENCE, BREACH OF CONTRACT, OR BREACH OF ANY STATUTORY OR OTHER DUTY OF CARE, INCLUDING ANY DUTY OF CARE OWED UNDER THE OCCUPIERS LIABILITY ACT, ON THE PART OF THE RELEASEES, AND FURTHER INCLUDING THE FAILURE ON THE PART OF THE RELEASEES TO SAFEGUARD OR PROTECT ME FROM THE RISKS, DANGERS AND HAZARDS OF PARTICIPATING IN MOUNTAIN BIKING REFERRED TO ABOVE;
2. TO HOLD HARMLESS AND INDEMNIFY THE RELEASEES for any and all liability for any property damage, loss or personal injury to any third party resulting from my participation in mountain biking;
3. This Release Agreement shall be effective and binding upon my heirs, next of kin, executors, administrators, assigns and representatives, in the event of my death or incapacity;
4. This Release Agreement and any rights, duties and obligations as between the parties to this Release Agreement shall be governed by and interpreted solely in accordance with the laws of the province where the mountain biking takes place and no other jurisdiction; and
5. Any litigation involving the parties to this Release Agreement shall be brought solely within the province where the mountain biking takes place and shall be within the exclusive jurisdiction of the Courts of that province.
I agree to the above
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Yes
In entering into this Release Agreement I am not relying on any oral or written representations or statements made by the Releasees with respect to the safety of participating in mountain biking, other than what is set forth in this Release Agreement.
I CONFIRM THAT I HAVE READ AND UNDERSTOOD THIS RELEASE AGREEMENT PRIOR TO SIGNING IT, AND I AM AWARE THAT BY SIGNING THIS RELEASE AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS, ASSIGNS AND REPRESENTATIVES MAY HAVE AGAINST THE RELEASEES.
By typing in your name below and clicking the “I Agree” icon, you agree to be bound by this Agreement.
Name (first & last)
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I Agree
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Yes
Am I legally able to agree to the waiver?
ALL
members under the age of 18 at time of application MUST have a parent/legal guardian submit a signed waiver to the ShortHills Cycling Club before your membership will become valid.
Memberships will NOT be processed for members under 18 without this signed waiver.
Please Note
the waiver is a legal document and cannot be agreed to by any other person for an individual over the age of 18. Misrepresentation of another individual is a crime and may result in the membership becoming null and void.
It is accecptable for the ShortHills Cycling Club to contact me via email regarding upcoming social events, rides or other club announcements
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Yes
No
Submit Registration Info
IMBA Canada/SHCC Waiver
File Size:
391 kb
File Type:
pdf
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