Albany Bike Rescue

Membership Application
Contact Information
First Name: _______________ Last Name: _________________________ Date: _______________
Phone: ___________________ Email Address: __________________________________________
Are you over 18?
Yes No
If not over 18, Member Birthdate: ___/___/____ Guardian Name: ____________________________
Waiver and Release of Liability - Read Before Signing!
The undersigned has read, acknowledges, appreciates, and agrees that:
1) I will follow the ABR Code of Conduct.
2) There are certain risks involved in participating in the Albany Bicycle Rescue including but not limited to: theft of my
property, damage to my property, personal injury, or death. I knowingly and freely assume all such risks while
participating in any Albany Bicycle Event.
3) There are certain risks involved with bicycling including but not limited to personal injury or death. I knowingly and
freely assume all such risks while riding a bicycle from Albany Bicycle Rescue or a bicycle that has been serviced at
any Albany Bicycle Rescue event.
4) In consideration of my being granted permission to participate in these activities and to use the facilities of Albany
Bicycle Rescue including the service of their volunteers, I, on behalf of myself, my executors, administrators, heirs,
next of kin, and successors herby covenant to release and hold harmless and indemnify Albany Bicycle Rescue and
all of the officers and volunteers and other participants from any all claims, lessees, damages, injuries, fines,
penalties, and costs (including court costs and attorneys fees), charges, liabilities, or exposure, however caused
resulting from, arising out of, or in any way connected to my familys participation in any activities at or with Albany
Bicycle Rescue.
In other words: Work and ride at your own risk!
Albany Bicycle Rescue highly recommends the use of helmets for riders of all ages.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS
TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY
AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
________________________________________________ Date Signed:__________________
(Participant's Signature)
FOR PARTICIPANTS OF MINORITY AGE
(UNDER AGE 18 AT THE TIME OF REGISTRATION)
This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her
release as provided above of all the Releasees, and for myself, my heirs, assigns, and next of kin, I release and agree to
indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child's involvement or
participation in these programs as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE.
________________________________________________ Date Signed:______________________
(Parent/Guardian Signature)
1

Albany Bike Rescue

Membership Application