Event Participation & Photo Release Agreement

1. Participant Information

First Name* Last Name* Student's Date of Birth* Email* School* Are you 18 or older?*

2. Parent/Guardian Information

First Name* Last Name* Phone Number* Email* Do you need a bike?* Home Address*

Parent/Guardian Signature*

3. Emergency Contact Information

First Name* Last Name* Relationship to Student* Email* Phone Number*

Secondary Emergency Contact (Optional)

4. Medical Needs (Optional)

Medical Needs Preferred Hospital or Medical Facility

Acknowledgements

Assumption of Risk & Liability Release

By participating in this activity, you acknowledge and assume all risks associated with cycling, including but not limited to potential falls, collisions, and environmental hazards.

Initial Signature*

Indemnification Clause

The participant agrees to indemnify and hold harmless the organizers and sponsors from any claims, actions, or liabilities arising out of participation in this event.

Initial Signature*

Emergency Medical Treatment Agreement

In case of an emergency, you authorize event organizers and medical professionals to provide necessary medical treatment. Costs for such treatment are the responsibility of the participant or guardian.

Initial Signature*

Photo & Media Release

By signing this waiver, you grant permission for photographs and video taken during the event to be used for promotional purposes by the organization.

Initial Signature*

Would you like to receive updates?

Signatures

Student Signature*

Date Signed*