BREAK THE CYCLE PARTICIPATION WAIVER

 

I, _____________________________ , certify and affirm that I have been completely and thoroughly informed that as a participant attending rides both  for training purposes and/or for recreational purposes with Break-n The Cycle Nonprofit Corp (“Break the Cycle”), I will participate in certain activities and acknowledge that such activities carry with them a degree of risk and danger. I acknowledge and understand that Break the Cycle may offer other activities not listed above that present similar risks or dangers to me. 

I consent to my participation in these activities. I acknowledge and understand that this CONSENT AND RELEASE has the same force and effect regardless of whether the activities engaged in are free or if a fee is charged. Further, I personally assume all risks in connection with said activities for any harm, injury or damages that may befall me as a result of my participation in the activities, whether foreseen or unforeseen. 

In consideration of my participation in these activities, use of various facilities, and use of equipment and a bicycle, whether provided by Break the Cycle or myself as a part of my participation with Break the Cycle, I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless Break the Cycle from any and all claims, demands, or causes of action, which are in any way connected with my participation in these activities or use of Break the Cycle or designated destination’s, equipment and facilities.

I understand that it is my obligation to inform the Break the Cycle of any and all health considerations or medical

conditions that would restrict my participation in any and all activities with Break the Cycle.  I recognize and acknowledge that my participation in activities despite such medical conditions is done at my own risk. 

In cases of emergency, I further consent to the examination or treatment of myself by a physician duly licensed to practice medicine in the United States of America or any health care professional duly licensed to provide health care services in the United States of America for medical care and services deemed necessary by the doctor, its agents, servants, and employees. 

I give permission to the doctor or health care professional to provide any and all medical care they deem, in their professional opinion, to be necessary. I agree to pay for any and all medical expenses incurred as a result of the use of this consent. 

I acknowledge by signing this document, that if anyone is hurt or property is damaged during my participation in these activities, I may be found by a court of law to have waived my right to maintain a lawsuit against Break the Cycle on the basis of any claim from which I have released them herein. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions remain in full force and effect. I have fully informed myself to the contents of this CONSENT AND RELEASE by reading it before signing it.