11 Mile or 31 Mile or 62 Mile Ride
A Community Bike Ride Fundraiser for Brighter Days Homeless Shelter in Columbus.
100% of Registration Fees and $$ Donations will go to the Homeless Shelter.
Date: Saturday, July 17, 2021 Time: Ride begins at 9am Location: 3850 N Marr Rd Columbus, IN
Community Church of Columbus Parking Lot
Cycling For Brighter Days Registration Form
Registration Fee $25 (100% fees donated Homeless Shelter. Non-refundable)
Name of Participant
Age of Participant
Which Ride will you be participating in?
10 Mile Ride
31 Mile Ride
62 Mile Ride (Loop 31 Mile twice)
Street Address Line 2
State / Province
Postal / Zip Code
Emergency Contact Phone Number
CROSSROADS ASSOCIATION OF REALTORS (CAR) - Release & Waiver 430 5th St., Columbus, IN 47201 RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT (“RELEASE”) In consideration of being permitted to participate in any way in a bicycle ride or other activity or event sponsored by Crossroads Association of Realtors, I, for myself, my heirs, personal representatives, successors, and assigns, intending to be legally bound, agree as set forth below.1. I acknowledge, agree, and represent that I understand that Bicycling is a potentially hazardous activity and I understand and assume the risks involved in participating in Bicycling. I acknowledge and agree that I should not voluntarily participate in Bicycling unless I am qualified, medically able, 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. I know that by participating in this voluntary Activity, I will be subject to adverse traffic conditions, road conditions and other hazards on public roads and facilities, potential adverse weather conditions, unsafe actions by other riders, unsafe actions by vehicle drivers and unsafe actions by non-participants and I assume all such risks.2. I fully understand that: (a) the act of participating in Bicycling or an Activity, involves risks and dangers of serious bodily injury, including permanent disability, paralysis, and death or other adverse health consequences, theft or loss of property or property damage of any kind or nature whatsoever ("Risks"); (b) these Risks may be caused by my own actions, or inactions, or by the actions or inactions of others participating in the Activity, the conditions under 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 as well as the Risks above and I fully accept and assume all responsibility for personal injuries, losses, damages, costs and expenses I may suffer or incur as a result of my participation in the Activity.3. I hereby release, discharge, indemnify and agree not to sue Crossroads Association of Realtors, its officers, directors and employees or volunteers, including, but not limited to any persons involved in organizing and promoting any Activity (collectively, “CAR”), CAR’s agents, association members, association ride leaders, affiliated officers, affiliated directors, other participants, any other sponsors, advertisers, promoters, and, if applicable, owners and lessors of any premises on which the Activity takes place, (each considered one of the "Releasees" herein) from all liability, claims, demands, losses or damages incurred as the result of my participation in the Bicycling Activity (including, but not limited to claims, losses, or damage caused or alleged to be caused, in whole or in part, by the negligence of a Releasee or otherwise); and I further agree that if, despite this Release, 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, loss, liability, damage, or cost which any of the Releasees may incur as the result of such claim.4. I hereby agree to wear a helmet and to refrain from wearing headphones or earphones or playing music when participating in any CAR ride. I also agree that the bicycle and any equipment I use to participate in any Activity has been inspected and is in good, working and safe condition.5. I hereby agree that I am solely responsible for my compliance with all traffic laws regardless of the conduct of other riders or ride leaders.Intending to be legally bound, I have carefully read this Release, I represent that I am at least eighteen years old, I fully understand its terms, understand that I have given up substantial rights by signing it, and have signed it freely and without any inducements or assurance of any nature and intend it to be a complete and unconditional release of all liability relating to Bicycling or other Activity to the greatest extent allowed by law, and agree that if any portion of this Release is held to be invalid, the balance of it, notwithstanding, shall continue in full force and effect.
Participant's Signature (18 years and up)
Parent or legal guardian signature for participant under 18 yrs. I accept full responsibility for the above mentioned minor during this entire CAR event.
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100% of registration fees will be donated to Love Chapel's Brighter Days Homeless Shelter.
Additional Donation $5 Increments
Number of Donations
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