(Read the "Who We Are" webpage describing the purpose of the GVCC)
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 Goleta Valley Cycling Club 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 he 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) these 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 looses, 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 the Club, the LAB, their respective administrators, directors, agents, officers, volunteers, and employees, other participants, any sponsors, advertisers, and, if applicable, owners and leasers of premises on which the Activity takes place, (each considered one of the "releasees" herein) from all liability, claim, 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 fee, loss, liability, damage or cost which any may incur as the result of such claim. 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.
Name
New Member? or Renewal?
Address:
Home Phone
Work Phone
Are you a member of the League of American Bicyclists? #
Birthdate (optional)
I certify that I am over 18 years of age. (If under 18 years of age, a separate release form must be obtained, signed by parent or guardian and submitted with this application.)
Signature
Date
1-Year Membership $15.00; 2-Year Membership $25.00. Make checks payable to GVCC
Print out webpage & mail completed application to GVCC, P.O. BOX 1547, Goleta, CA 93116-1547.