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SJW Convention October 17
- 19, 2008
East Lake Cabin, Belleplain State Park, New Jersey
Convention Reservation *list
all names in party at bottom of page. All MUST sign next to name.
Contact Name: _____ __________
________ Telephone
#: _______________
Address: ___________________________________________________
Town/State/Zip: _________________________________________
E-mail: ______________
_ __ SJW
Member? : _ _Yes _ _No
You must be a member or the quest of a member.
Enclose check made to: South Jersey Wheelmen. Cost: $30
per person.
(*Write "Convention 08" on memo
line) Send check to: Al Jackson,
514 Buck St. Millville, NJ 08332
LEAGUE OF AMERICAN WHEELMEN d/b/a LEAGUE OF AMERICAN BICYCLISTS
("LAB") RELEASE AND WAIVER OF LIABILITY, ASSUMPTION
OF RISK, AND INDEMNITY AGREEMENT ("AGREEMENT") IN
CONSIDERATION of being permitted to participate in any way in
South Jersey
Wheelmen
("Club") sponsored Bicycling Activities ("Activity")
I for myself, my personal representatives, assigns, heirs, and
next
of kin:
1. ACKNOWLEDGE, agree, and represent that I understand the nature
of Bicycling Activities and that I am qualified, in good health,
and in proper physical condition 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.
2. FULLY UNDERSTAND that: (a) BICYCLING ACTIVITIES INVOLVE RISK
AND DANGERS 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 conditions in which
the Activity takes place, or THE NEGLIGENCE OF THE "RELEASEES" NAMED
BELOW; (c) 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 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, AND COVENANT NOT TO SUE the Club,
the LAB, their respective administrators, directors, agents,
officers,
members, volunteers, and employees, other participants, any sponsors,
advertisers, and, if applicable, owners and lessors of premise
on
which the Activity takes place, (each considered one of the "RELEASEES"
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 "RELEASEES" OR OTHERWISE, INCLUDING
NEGLIGENT RESCUE OPERATIONS; AND I FURTHER AGREE that if despite
this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY
AGREEMENT I, or anyone on my behalf, makes a claim against any
of
the Releasees, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS EACH
OF THE RELEASEES from any litigation expenses, attorney fees, loses,
liability, damage, or cost which any may incur as the result of
such claim.
I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND
THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE
SIGNED FREELY AND WITHOUT ANY INDUCEMENT OF 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 IF FULL FORCE AND EFFECT.
NOTE: This release MUST be signed before you
can participate. Helmets required, no headphones.
__________________________________________________Date_____________________________
Signature of Main Contact
Name______________________________________ signature__________________________________________
Name______________________________________ signature__________________________________________ |