Accident Waiver & Liability Release Form

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To participate, the following TWO statements must be read and agreed to with your signature in ink on the registration form.

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ACCIDENT WAIVER & LIABILITY RELEASE FORM

REALITIES FOR CHILDREN

ACCIDENT WAIVER AND RELEASE OF LIABILITY

I acknowledge that this athletic event is an extreme test of a person’s physical and mental limits and carries with it the potential for death, serious injury and property loss. The risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of athletes, equipment, vehicular traffic, action of other people including, but not limited to, participants, volunteers, spectators, coaches, event officials, and event monitors, signage, and/or producers of the event and lack of hydration. These risks are not only inherent to athletics, but are also present for volunteers. I hereby assume all of the risks of participating and/or volunteering in this event. I realize that liability may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained or controlled by them or because of their possible liability without fault. I certify that I am physically fit, have sufficiently trained for participation in the event and have not been advised otherwise by a qualified medical person. I acknowledge that this Accident Waiver and Release of Liability (AWRL) form will be used by the event holders, sponsors and organizers, in which I may participate and that it will govern my actions and responsibilities at said events. In consideration of my application and permitting me to participate in this event, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) Waive, Release and Discharge from any and all liability for my death, disability, personal injury, property damage, property theft or actions of any kind which may hereafter accrue to my including my traveling to and from this event, the following persons: Pedal to the Point Turning Point Bike Tour, their directors, offices, employees, volunteers, representatives, and agents, the event holders, event sponsors, event directors, event volunteers (collectively “Releasee”); (B) Indemnify and Hold Harmless the Releasees from any and all liabilities or claims made as a result of participation in this event, whether caused by the negligence of Releasee or otherwise. I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and or illness during this event. I understand that at this event or related activities, I may be photographed. I agree to allow my photo, video or film likeness to be used for any legitimate purpose by the event holders, producers, sponsors, organizers and/or assigns. This AWRL shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. I hereby certify that I have read this document; and, I understand its content. I also understand that my registration fees are non-refundable.

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Riding safely and considerately is vital to the safety and enjoyment for all riders. The future of cycling events in Colorado depends upon your cooperation in following safe cycling practices. I agree to the following: • Ride single file except to pass when possible • Wear a helmet at all times while riding • Ride as far to the right side of the road as practical • Always carry personal identification • Obey all traffic regulations, signs, and lights.

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SAFE & CONSIDERATE RIDING AGREEMENTS:

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presents

Overland Sertoma‛s

2009

Sunday, August 9, 2009

Rain or Shine

Ride With Us! Family Fun · After-Ride BBQ

Register online at www.active.com Questions? 970.567.6459

PARENT GUARDIAN WAIVER FOR MINORS (UNDER 18 YEARS OLD)

The undersigned parent and natural guardian of legal guardian hereby represent that he/she is, in fact, acting in such capacity and agrees to save and hold harmless and indemnify each and all of the parties referred to above from all liability, loss, cost, claim or damage whatsoever which may be imposed upon said parties because of any defect in or lack of such capacity to so act and release said parties on behalf of the minor and the parents or legal guardians. Indicate your agreement to the above TWO statements with your signature on the registration form.

www.turningpnt.org

Here’s What you Need to Know

Pedal to the Point Bike Tour 2009 Entry Form

• Sunday, August 9, 2009 • 7:00 a.m. • Waverly School 10431 N. County Rd 15 Waverly, CO 80524

One registration form per rider. Please print. Or register online at www.active.com

Brief Description:

Name:___________________________________________ Address:_________________________________________ City:______________________ State:_____ Zip:______ Day Time Phone: ________________________________ E-mail: __________________________________________ Age:_______ Sex: o Male o Female Select Route: o 72 Mile o 52 Mile o 24 Mile

WHEN: WHERE: TIME:

Fully supported 24, 52 and 72 mile rides designed for every age and ability. Unique routes offer a variety of terrain and scenery from open farmland north of Fort Collins to the streets of Loveland.

Three routes to choose from: Family Ride (24 miles)

FEES:

(100% donation to Turning Point to benefit high risk youth in Northern Colorado) 1 Adult Rider - $40 1 Adult & 1 Youth under 18 - $60 1 Adult & 2 or more children - $100

This route is great for the beginner cyclist. An easy ride with flat roads, ride north into scenic farmland and open fields and back south to the town of Wellington, then head northwest back to Waverly School.

Send check or pay by credit card:

Visa/MasterCard:_________________________________ Exp. Date: ____________

Distance Ride (52 miles) Intermediate cyclists follow a majority of the 24-mile route but continue south at Wellington past the Budweiser factory and into Fort Collins, riding much of what is called the “cement factory loop” by many local cyclists. A great ride with flat straightaways and rolling hills.

_____________________________________________ Printed name of cardholder

_______________________________________________ Signature of Cardholder

Endurance Ride (72 miles) If you’re in for the long haul, this route is for you. Ride south through Timnath and into Loveland, then back north into Fort Collins alongside Hughes Stadium. Wind into Laporte, and enjoy the drastic change in scenery back to Waverly.

Register online at www.active.com or complete attached registration form

Sunday, August 9, 2009 Waverly School 10431 N. County Road, Waverly, CO 7:00 a.m.

Proceeds from Pedal to the Point support mental health, counseling, substance abuse treatment and education services for Turning Point Youth and their families. Turning Point is a Colorado 501(c)3 non profit organization.

I have read the “Safe & Considerate Riding Agreement” and the “Accident Waiver and Release of Liability” and agree to all of the terms and conditions. I understand I am giving up substantial rights by signing this AWRL; that this is a complete and total release of liability and indemnification that Releasee shall rely upon with the intent that it is a complete and unconditional release of all liability to the greatest extent allowed by law. Signature (in ink): _____________________________________Date: _______ (If under age 18, parent/guardian must sign)

For additional Information: Call 970.567.6459 or e-mail [email protected] Mail: Turning Point 1644 S. College Ave. Fort Collins, CO 80525 Fax: 970.221.2727