Test Ride Booking Waiver Form
This waiver states that you are taking full responsibility for any personal injury to you and/or to others and any damage to the bike that may occur during your test ride, but most importantly, for having a good time!
Email
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example@example.com
Name
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First Name
Last Name
Phone Number
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Please enter a valid phone number.
Zip Code
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Which bike are you interested in?
Please Select
Tern GSD
Tern HSD
Tern Quick Haul
By checking the boxes, you confirm that you agree with the following statements:
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ACKNOWLEDGMENT OF RISKS: I recognize that there are inherent risks in e-bike riding. These risks may result in serious injury or death, and include but are not limited to the following: 1) Falls; 2) Collisions with pedestrians, other cyclists, vehicles, manmade and natural objects; 3) Hazards of trails, routes or roadways including uneven or unstable surfaces, steep grades, sharp turns, and or; 4) the presence of water, sand, gravel, mud, oil, and debris which may inhibit my ability to maneuver or stop; 5) Cold weather and heat related injuries or illness, including hypothermia, frosting, frostbite, heat exhaustion, heat stroke, and dehydration: 6) Climatic conditions, such as rain, fog that makes it difficult to see and be seen, varied or severe wind; 6) lack of physical coordination, inability to balance or control a bicycle; 7) cycling too fast, 8) failing to follow directions; 9) Equipment failure including tire puncture and problems in shifting and or braking; 10) Loss of or damage to personal property; 11) Fatigue, chill and or dizziness, which may diminish my reaction time and increase the risk of an accident; 12) Accidents or illnesses occurring in remote places where there are no available medical facilities. I understand the description of these risks is not complete and that unknown or unanticipated risks may result in injury, illness, or death. WOMBI AND THE CITY OF BEVERLY HILLS IS NOT LIABLE FOR ANY DAMAGE/INJURY CAUSED while riding the Tern e-bike. I understand the use of alcohol or drugs may impair my abilities, and may make it unlawful to operate an e-bicycle. EXPRESS ASSUMPTION OF RISK AND RESPONSIBILITY: I agree to assume responsibility for those risks identified herein and those not specifically identified. I elect to participate in spite of the risks. I certify that I am (we are) physically and mentally capable of participating in this activity. My participation in this activity is purely voluntary. I agree that it is my responsibility to know how to properly ride and operate the use of the bicycle. If I feel the bicycle is not functioning properly, I will stop using it and have it inspected, repaired, or adjusted by a qualified technician. Head injuries pose a serious risk to bikers. I understand the benefit of wearing and approved safety helmets while cycling. I understand that all participants under the age of 18 must wear a helmet [California Vehicle Code 21212 (a)]. I agree to wear a helmet, even if I am over the age of 18. If I choose to ride the bicycle in the streets, I agree to obey all traffic laws, signs, local regulations, and the rules of the road for bicycles. I assume full responsibility for myself and any minor children for which I am responsible, for bodily injury, accidents, illness, death, loss of personal property, and any related expenses. Further, I agree to return all rental equipment in clean condition. I accept full responsibility for the care of the equipment. I will be responsible for the replacement, at full retail value, of any equipment that is damaged or not returned to Wombi Mobility. RIGHT TO TERMINATE SERVICE: I recognize that you may find it necessary to terminate my use of the e-bicycle due to forces of nature, medical necessities, or problems in the group, and that you may refuse or terminate my participation or the participation of any person you judge to be incapable or meeting the rigors or requirements of using the e-bicycle. I accept your right to take such actions for the safety of myself and or other participants. I acknowledge that no guarantees have been made with respect to cycling objectives.
LIKENESS CONSENT: I agree that any film or photographs (images) of me/us, as participants, that are shared with Wombi may be used for promotional or commercial purposes, and that I will receive no money unless it is deemed an official photo/video shoot. I have carefully read and fully understand the foregoing warning, acknowledgement of risks, assumption of risk and responsibility, and release of liability. I understand that by signing this document I am waiving valuable legal rights, including the right to sue, and sign it freely and willingly.
Signature
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