PEDAL ACROSS WISCONSIN, INC.
TOUR FEES WINDSHIRT: 100% microfiber, the new high-tech materials
that breathes going up hill better than you do. Machine washable with
wrist and waistbands for extra comfort. Long-sleeved. TOTAL TOUR FEES $____________ |
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In signing this release, I acknowledge that I understand the nature of the Pedal Across Wisconsin, Inc. tour (‘activity’) and that it is a potentially hazardous event, and attend it of my own free will and choice. In choosing to attend Pedal Across Wisconsin, Inc.’s activity and any related events or activities, I fully assume all risks, whether before, during or after the Pedal Across Wisconsin, Inc. activity or related activities. These include, without limitation, collision with pedestrians, vehicles, other riders, sponsors, promoters, or drivers, and dangers arising from falls, camping, theft, road surface, equipment failure, inadequate safety equipment, weather conditions, as well as the possibility of physical and/or mental trauma, mental injury, emotional stress, serious bodily injury resulting in disability, death and paralysis. I realize Pedal Across Wisconsin, Inc. activities require physical conditioning, and I represent myself that I am in sound medical condition, capable of participating without risk to myself and others. I have no medical impediment that would endanger myself or others. I waive any and all specific notices of risks. I agree that maps, directions, leaders and road markings are provided for my convenience only, and not to guarantee a safe route or trip. I understand and agree that a situation may arise during the Pedal Across Wisconsin, Inc. activity which may be beyond the control of the sponsors, promoters, or organizers, and agree to participate so as not to endanger myself and others. I understand that any route or activity chosen as part of our outdoor adventure may not be the safest, but has been chosen for the interest or challenge provided. I understand the route requires bicycling on public roadways, and in bad weather, and that cyclists have been hospitalized and/or killed because of accidents that are either their responsibility or the responsibility of someone else. I further agree that I will bear and assume all expenses incurred in any accidents, illness, or loss of any kind. 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 hereby consent to and permit emergency treatment in the event of injury, illness or death. I give full permission for use of my name and photograph, motion pictures, video tape, recording, written comments or opinions, or other records of this event for any legitimate purpose. Pedal Across Wisconsin, Inc. reserves the right to decline accepting or retaining any tour participant whose health or actions impede the operation of the tour, or welfare of other tour participants. An approved (ANSI or Snell or equal) helmet is strongly recommended for use by all participants while riding bicycles. I agree to the terms and conditions of the Pedal Across Wisconsin, Inc. cancellation policy. I park my vehicle at my own risk and acknowledge the safe-keeping of my bicycle as my responsibility. I have read this agreement, fully understand all the terms it contains, and understand that I have given up substantial rights by signing it freely, and without any inducement or assurance of any nature, and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law, and agree that if any portion of this agreement is held to be invalid, the balance notwithstanding, shall continue to be in full force and effect. Any action to interpret or enforce it shall be brought in Kane County, in the State of Illinois. The foregoing understood and agreed, I hereby release and waive any and all claims against Pedal Across Wisconsin, Inc. sponsors, workers, volunteers, organizations, schools, businesses, and any other parties connected with this event in any way (‘releasees’) singularly or collectively, and further hold harmless and indemnify such releasees from and against any liability, claims of negligence, misadventure, harm, loss, inconvenience, or damage hereby suffered or sustained as a result of participation in the Pedal Across Wisconsin, Inc. tour, or any other activity associated herewithin. Such release, waiver, hold harmless and indemnity shall apply to my own claims and/or claims of third parties, relating to my participation in this event. 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 Pedal Across Wisconsin, Inc. or other sponsors or affiliated organizations and their respective agents, officers, and employees for any and all damagers, injuries or claims which may be sustained by me directly or indirectly arising out of my participations in Pedal Across Wisconsin, Inc. I agree to abide by the rules of the road and certify that I have read the Pedal Across Wisconsin, Inc. safety letter and agree with the advice and procedures therein. The undersigned acknowledges having read and agreed to the terms of the foregoing Release and Waiver of Liability agreement. EACH PARTICIPANT MUST SIGN A SEPARATE WAIVER _______________________________________________ Signature of Adult Participant Date ______________________________________________________ Printed Name ______________________________________________________ Or, the following signatures if rider is a minor (under age 18): Parent or guardian must be on ride. ______________________________________________________ Signature of Minor Date ______________________________________________________ Printed Name of Minor ______________________________________________________ Signatures of both parents (or guardian) Date Cancellation Policy:. 90 days notice: 100% refund 60 days notice: 100% refund minus $20.00 30 days notice: 100% refund, minus $30.00 14 days notice: 100% refund, minus $40.00 7 days notice: 100% refund, minus $54.00 6 days or less: 100% refund, minus $74.00 Please complete registration form, read and sign waiver, and enclose minimum 50% deposit. Checks should be made out to: ‘Pedal Across Wisconsin, Inc.’ Sorry, we do not take credit cards. If you have any questions, please contact Dr. J. Pedal at 847-707-6888 or email him at drjpedal@sbcglobal.net. |