Cape Cod Cycling Club

* First Name:   For household, use "-" between names
*Last Name:
Street:
City:
State:      Zip:
*E-Mail: Required for on-line registration
Home Phone: (555-555-5555)
Alt. Phone: (555-555-5555)

* Membership: Individual (New) $40.00
  Individual (Renewal) $35.00
  Household $60.00   *Number of Members

*Payment Method: Membership will activate when payment is recieved

In what ways would you like to participate in the club and what activities would you like the club to offer?

Read Waiver carefully and check "I Agree" to accept.
*Waiver of Liability:

RELEASE OF LIABILITY(READ CAREFULLY AND CHECK "I AGREE" TO ACCEPT THIS WAIVER OF LIABILITY.
RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AND PARENTAL CONSENT
AGREEMENT ("AGREEMENT")
IN CONSIDERATION of being permitted to participate in any way in Cape Cod Cycling Club ("CCCC") sponsored
bicycling activities ("Activity"), I, for myself, my personal representatives, assigns, heirs, and next of kin:
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
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 condition in which the Activity takes place, or THE NEGLIGENCE OF THE "RELEASEES" NAMED
BELOW;
(c)there may be OTHER RISKS AND SOCIAL AND 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 RESPONSIBILITY FOR
LOSSES, COSTS, AND DAMAGES I incur as a result of my participation or that of the minor in the Activity.
3. HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE CCCC, their respective administrators, directors,
agents, officers, members, volunteers, and employees, other participants, any sponsors, advertisers, and if applicable,
owners and lessors of premises on which the Activity takes place, (each considered one of the "RELEASEES" 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 "RELEASEES" OR OTHERWISE, INCLUDING
NEGLIGENT RESCUE OPERATIONS; AND I FURTHER AGREE that if, despite 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 Releasees from any
litigation expenses, attorney fees, loss, liability, damage, or cost which any may incur as the result of such claim.
4. ABIDE BY AND RESPECT ALL RULES set forth by CCCC as it pertains to any CCCC rides or activities.
I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP
SUBSTANTIAL RIGHTS BY SIGNING IT AND 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 EFFECT.
FOR MINORS :
I, THE MINOR'S PARENT AND/OR LEGAL GUARDIAN, UNDERSTAND THE NATURE OF BICYCLING ACTIVITIES
AND THE MINOR'S EXPERIENCE AND CAPABILITIES AND BELIEVE THE MINOR TO BE QUALIFIED, IN GOOD
HEALTH, AND IN PROPER PHYSICAL CONDITION TO PARTICIPATE IN SUCH ACTIVITY. I HEREBY RELEASE,
DISCHARGE, COVENANT NOT TO SUE, AND AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS EACH OF
THE RELEASEES FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON THE MINOR'S ACCOUNT
CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE "RELEASEES" OR
OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS AND FURTHER AGREE THAT IF, DESPITE THIS
RELEASE, I, THE MINOR, OR ANYONE ON THE MINOR'S BEHALF MAKES A CLAIM AGAINST ANY OF THE
RELEASEES NAMED ABOVE, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES FROM
ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS LIABILITY, DAMAGE, OR COST ANY MAY INCUR AS THE
RESULT OF ANY SUCH CLAIM.

*I Agree *Initials:

Cape Cod Cycling Club On-Line Registration