Bass Lake Double Century
Registration

First Name(*)
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Last Name(*)
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Address(*)
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City(*)
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State(*)
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ZIP Code(*)
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Day Phone(*)
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Gender
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Email(*)
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Date of Birth(*)
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Emergency Contact(*)
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Emergency Phone(*)
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Prior Finisher
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Registration(*)

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Registration(*)

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Registration(*)

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Included (with Registration before 9/10/2015) Socks Size
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Additional Meals
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Qty Extra Meals
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In consideration of being permitted to participate in any way in Fresno Cycling Club (“Club”) sponsored activities (‘Activity”), I, for myself, and for my personal representatives, assigns, heirs and next of kin: (1) Acknowledge, agree and represent that Interest and the nature of cycling Activity and that I am qualified to participate in such Activity. I further acknowledge that the Activity will be conducted over public roads and byways open to the public during the Activity and upon which 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 IN VOLVE RISK AND DANGER 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 “RELEASES” NAMED ABOVE; (c) there may be OTHER RISKS AND SOCIAL AND ECONOMIC LOSSES either known or unknown 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 in the Activity. (3) HEREBY RELEASE, DISCHARGE, COVENANT NOT TO SUE AND AGREE TO INDEMNIFY AND HOLD HARMLESS the Club, the League of American Bicyclists, their respective administrators, directors, agents and employees, other participants, any sponsors, advertisers and if applicable, owners and lessees of premises on which the Activity takes place (each considered one of the Releases' 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 “RELEASES” OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS. I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I AM GIVING 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 LIABILTY TO THE GREATEST EXTENT ALLOWED BY LAW, AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS INVALID, THE BALANCE NOTWITHSTANDING SHALL CONTINUE TO BE IN FULL FORCE AND EFFECT.

Total
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