Example Waiver

BERKELEY HIGH SCHOOL MOUNTAIN BIKE RACING TEAM AND CLUB

1999-2000 SCHOOL YEAR MEMBERSHIP APPLICATION

NAME: _________________________________________________ (first/mid/last)

SEX male female AGE: ____ BIRTH DATE: ___/____/___(M/D/Y)

ADDRESS: ______________________________________________ (street & apt #)

CITY: ____________________________ STATE: ______ ZIP: ___________

PHONE#: ( ) ________________ home ( ) ________________ work

EMERGENCY PHONE #: ( ) _____________________

NAME AND RELATIONSHIP OF EMERGENCY CONTACT: __________________

BERKELEY HIGH SCHOOL MOUNTAIN BIKE RACING TEAM AND CLUB RELEASE AND WAIVER: (must be signed and dated)

In consideration of being permitted to participate in any "Berkeley High School Mountain Bike Racing Team and Club"(BHS Mountain Bike Team) sponsored Bicycle Activities, I for myself, my personal representatives, assigns, heirs, and next of kin:

Acknowledge, agree and represent that I understand the nature of Bicycle Activities and that I am qualified 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.

I agree that prior to participation I will inspect the equipment I am using, and if I believe any of them to be unsafe I will not participate in that event.

I warrant that I am in good health, physically fit, and have no physical conditions that would prevent me from participating in and BHS Mountain Bike Team event I choose to participate in.

I acknowledge that the BHS Mountain Bike Team requires the wearing of a Hard Shell Helmet when riding a bicycle. I also acknowledge that the BHS Mountain Bike Team requires some form of identification (Drivers License, California ID, Student ID), a current medical card and Emergency Contact information when riding a bicycle, (e.g., SELF SUFFICIENT)

Furthermore I agree to abide by the rules and regulations of events, vehicle laws of the State of California and any local municipal laws applicable.

I FULLY UNDERSTAND THAT:

With the full knowledge that bicycle riding is a hazardous activity which involve risks and even dangers of serious bodily injury, and that these risks and dangers may be caused by my own actions, or inaction, the actions of others participating in the Activity, the condition in which the Activity takes place, or the negligence of the "Releasees" named below; and that 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 I assume all such risks and all responsibility for losses, cost and damages I incur as a result of my participation in the activity attendant thereto, and thus release, and agree to indemnify and save and hold harmless, waiver and forever discharge the BHS Mountain Bike Team and its officers, directors, employees, agents, volunteers, administrators, other participants, etc. (Each considered one of the "Releasees" herein) from any and all liability, responsibility and/or property damage, losses, damages, claims, demands or causes of action against them arising from or attributable to my participation in the "BHS Mountain Bike Team" event or activity. I also release, waive, discharge, and relinquish anybody associated with the "BHS Mountain Bike Team" including, any sponsors, volunteers, advertisers, and if applicable, owners and leasers of premises on which the Activity took place, any involved public entity, and their respective owners, officers, employees, agents, representatives, successors and assigns (Each considered one of the "Releasees" herein) from any and all liability, responsibility and/or property damage which I sustain during my participation in any "BHS Mountain Bike Team" event or activity.

This waiver and release covers myself and all parties herein and all heirs, executors or administrators thereto, and is given in full awareness of its content and in consideration of acceptance of my application.

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I HAVE READ THIS AGREEMENT, FULLY ____________________________

UNDERSTAND ITS TERMS, AND ACCEPT SIGNATURE

ALL OF THE ABOVE. I CERTIFY THAT I

AM AT LEAST 18 YEARS OF AGE.

I AM NOT 18 YEARS OF AGE OR OLDER. ____________________________

MY PARENT OR LEGAL GUARDIAN HAS PARENT/GUARDIAN

READ THIS AGREEMENT, FULLY SIGNATURE

UNDERSTANDS ITS TERMS, AND ACCEPTS

ALL OF THE ABOVE AND IS SIGNING IN _____/_____/________ DATE

MY BEHALF