Michiana Bicycle Association

Membership*

Membership $0.00 - $25.00

First Name*

Last Name*

Email*

Address*

Postal Code*

Country*

Phone Number*

Birth Date*

Gender*

Female

Male

Waiver Agreement*

I agree to the Michiana Bicycle Association Member Waiver

RELEASE, WAIVER, AND INDEMNIFICATION AGREEMENT. Every physical activity carries some measure of risk, ranging from minor strains and bruises to serious injury, including death. As the COVID-19 pandemic has taught us, simply gathering among other people may carry risks such as contracting illness. I recognize those risks as well as the risks inherent in bicycling activities (i.e., from road conditions, other cyclists, weather, livestock, etc.) and understand neither I nor my children or wards will be allowed to participate in bicycling events or their related activities unless we give up the right to hold the hosts and organizers of the events responsible for any injuries or damages we might suffer. So, on behalf of myself, my children or wards, our heirs, and anyone else who might claim to represent us or act in our place or on our behalf, I agree to the following: • I release Michiana Bicycle Association, Inc., and all of its officers, employees, volunteers, agents and representatives (collectively, “the released parties”) from any liability for any injuries, losses, or damages to person or property. • This release will bar any and all claims against the released parties, no matter how those claims might arise. Even if the released parties’ own negligence leads to injury or loss, this agreement will protect the released parties from liability or suit. • To fully shield the released parties, I will defend them, indemnify them, and hold them harmless from any liability or losses they might incur, including attorney’s fees, resulting from any claims, demands, or lawsuits that might arise out of our participation in the bicycling events. • Since publicity is an important part of the events, I will allow the released parties to use my or my child’s or ward’s name and likeness as they see fit in any advertising, photographs, video, or recordings, and I waive the right to inspect or approve any media the released parties might create or use. • I understand Michiana Bicycle Association, Inc., is an Indiana not-for-profit entity, and I agree that this agreement must be interpreted, governed, and applied according to Indiana law. I have read this entire document. I understand what it means, I understand it is a binding agreement, and I sign it or e-sign it voluntarily to participate in the bicycling event.

I agree to the Race Entry Waiver

I, the undersigned member (and my parent or guardian if I am younger than 18 years of age), intending to be legally bound, do hereby forever release and waive any and all rights, claims, and actions for damages that we, our heirs, executors, administrators, and assigns may have, or that may hereafter accrue against any and all persons, organizations, and other entities associated with the organization, including, but not limited to Race Entry, sponsors, affiliates, volunteers, Michiana Bicycle Association Management, arising out of or in connection with my involvement before, during, or after the association membership.

I verify that I am physically fit and sufficiently capable to participate in this membership and I assume the risks involved in this active membership. I further attest that I will be mindful of risks related to membership, and hold said sponsors and organizers blameless in any harm that may happen.

I consent to the collection and use of my Personal Information as contained in the Privacy Policy. I also give my permission for the free use of my name and/or pictures in telecasts, broadcasts, newspapers, posters, advertising, etc.

I also acknowledge understanding that the charge to my card will show up as Race Entry. I acknowledge that the online processing fees and charitable donations are non-refundable. I also acknowledge that any charitable donations will have 4.97% withheld from the donation to pay credit card and administrative costs.

Race Entry shall not be liable to me for any direct, indirect, special, incidental, consequential or exemplary damages including, but not limited to, loss of profits, goodwill, use, data or other intangible loses. Race Entry does not guarantee the completeness or accuracy of any information contained in, or provided in conjunction with the http://www.raceentry.com website. Race Entry is not responsible for any omissions or inaccuracies, or for the results obtained from this information.

Race Entry facilitates registration for various events, some of which allow memberships under the age of thirteen (13). We require a submission of birth date for all membership entries. For children under the age of thirteen (13), parental or guardian consent is required.

I agree that the statutes and laws of the State of Utah, USA, will apply to all matters relating to this Agreement and Waiver. I irrevocably consent that exclusive jurisdiction for any dispute with Race Entry relating to this Agreement and Waiver resides in the courts of Utah, and I further agree and expressly consent to the exercise of personal jurisdiction in the courts of Utah in conjunction with any such dispute including any claim involving Race Entry.

Waiver Initials*