for Membership in the
Name (s): ________________________________ Age(s): _______________
Address: _________________________________ City/State/Zip:__________
Emergency Contact (Person & Phone): ___________________________
Annual membership fee is $12 per
individual or $15 per family membership are due on May 1st.
For myself, my heirs,
executors, administrators, legal representatives, assigns, and successors in
interest (collectively referred to as "successor" in this document), I
RELEASE, FOREVER DISCHARGE AND AGREE NOT TO SUE the Manteca Bicycle Club (MBC),
its members, sponsors, promoters, and promoting organizations, other riders, and
property owners, law enforcement agencies, public entitles and special districts
(and their respective agents, officials, and employees) through or by which
cycling events and activities are conducted, from any and all liability, claims,
loss, cost or expense, including but not limited to, those arising from property
damage or loss, injury to my body, mental trauma, or death, and to waive any
such claims against any such persons or organizations, arising directly or
indirectly from, or attributable in any legal way to, any negligence or other
action or omission to act of any such persons or organizations, in connection
with sponsorship, organization or conduct of any bicycle riding or sporting
event or activity, including travel to or from such event or activity, in which
I may participate as a rider, club or team member, spectator, official or
I agree it is my sole
responsibility to be familiar with applicable rules or special regulations for
MBC cycling events or activities. I
must continually ride so as to neither endanger others or myself.
I accept responsibility for the condition and adequacy of my riding
equipment. I will ride wearing a
helmet, and assume all responsibility and liability for the selection of such a
helmet. I have no physical or
medical condition, which to my knowledge, would endanger others or myself if I
participate in bicycling events.
I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN MYSELF AND THE MANTECA BICYCLE CLUB AND SIGN IT OF MY OWN FREE WILL.