If you would like to use this form, please type in the required information, print the form using your browser's PRINT function, and mail it to the address below with your check. Make checks payable to RAIN 2008. Don't forget to sign and date the waiver below.
c/o Bloomington Bicycle Club
P.O. Box 463
Bloomington, IN 47402-0463
|THIS RELEASE MUST BE SIGNED AND DATED, OR YOUR ENTRY WILL BE RETURNED.|
I, the undersigned, freely acknowledge and realize the dangers of participation in RAIN 2008 and fully assume all risks including, but not limited to, collision with pedestrians, vehicles, other riders, and/or fixed or moving vehicles, other riders, sponsors, promoters, or drivers, and dangers arising from falls, road surface, equipment failure, inadequate safety equipment, weather conditions, as well as the possibility of physical and mental trauma. I understand that the route requires bicycling on public roadways and in bad weather and that cyclists have been hospitalized and killed because of traffic mishaps that are either their responsibility or others responsibility and I further agree that I will bear all expenses incurred in any such accidents.
I realize that RAIN 2008 requires physical conditioning and I represent that I am in sound medical condition. I have no physical or medical impediments which would endanger myself or others. I understand and agree that a situation may arise during RAIN 2008 which may be beyond the control of the sponsors, promoters or organizers and agree to ride so as not to endanger either myself or others.
I waive, release, discharge for myself, my heirs, executors, administrators, legal representatives (including successors), any and all rights and/or claims which I have, may have or may hereafter accrue to me against the sponsors and promoters of RAIN 2008 including the Bloomington Bicycle Club, J & B Event Management, Inc., Plainfield High School, Franklin Township Middle School, Dunreith Fire Department, and Earlham College, or their sponsors or affiliated organizations and their respective agents, officers and employees, for any and all damages, injuries or claims which may be sustained by me indirectly arising out of my participation in RAIN 2008. The above agreements and representations are my express understandings of the risks and I assume these voluntarily and freely without coercion or duress. This agreement may not be modified orally and may not be waived in any respect. I accept responsibility for the condition and adequacy of my bicycle, will wear a helmet as required, and will carry water and personal identification at all times, and agree to abide by the rules of RAIN 2008.
Sign and date below, or in the case of a minor, the parent/legal guardian must sign and date. If not properly signed, your entry will be returned.
SIGNED (Guardian if under 18) : _______________________________________ DATED: ____________________