Submit a separate form for each rider. This form may be duplicated. A separate Release Agreement (below) must be signed and returned for each adult rider. For riders under age 18, the Parental Consent Agreement (below) must be completed instead. The National Capital Bicycle Tour takes place October 4, 1998 rain or shine. All tour fees are non-refundable.
____________________________________________________________________________ Last Name (print or type) ____________________________________________________________________________ First Name ____________________________________________________________________________ Address ____________________________________________________________________________ City State Zip ____________________________________________________________________________ Home Phone Work Phone
Please circle your intended tour. (You can change your mind on the day of the ride.)
Contact in case of emergency: ____________________________________________________________________________ Name Phone Will this person be with you on the ride?___________________________________
Registrations postmarked or faxed no later than September 14 will receive a free T-shirt (to be distributed at the ride).
T-Shirt Adult Sizes: ( ) S ( ) M ( ) L ( ) XL
Fees: Current WABA Member ........................................$20 Team Participant ...........................................$20 Name of Team: ___________________________________________ Non-WABA Member ............................................$25 Tour with Special WABA Membership ..........................$40 Student (no T-shirt) .......................................$15 Children Aged 6-12 (no T-shirt, must ride with an adult) ...................................$10 T-Shirt (if registering after Sept. 14) ....................$10 Total: ________ Method of Payment: ( ) Visa or MasterCard ( ) Check Fax credit card registrations to WABA at 202-628-4141. ____________________________________________________________________________ Card Number Exp. Date ____________________________________________________________________________ Signature ____________________________________________________________________________ Print Name Make checks payable to and mail to: Phone: 202-628-2500 Washington Area Bicyclist Association FAX: 202-628-4141 733 15th Street, NW, #1030 E-mail: waba@waba.org Washington, DC 20005 Website: www.waba.org
IN CONSIDERATION of being permitted to participate in any way in the Washington Area Bicyclist Association ("Club") sponsored National Capital Bicycle Tour ("Activity") I, for myself, my personal representatives, assigns, heirs, and next of kin:
I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND HAVE SIGNED IT FREELY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT.
PRINTED NAME OF PARTICIPANT:____________________________________________________ ADDRESS:________________________________________________________________________ (Street) (City) (State) (Zip) PHONE:_____________________________ PARTICIPANT'S SIGNATURE:________________________________________________________ (only if age 18 or over) DATE:____________________________
AND I, THE MINOR'S PARENT AND/OR LEGAL GUARDIAN, UNDERSTAND THE NATURE OF BICYCLING ACTIVITIES AND THE MINOR'S EXPERIENCE AND CAPABILITIES AND BELIEVE THE MINOR TO BE QUALIFIED, IN GOOD HEALTH, AND IN PROPER PHYSICAL CONDITION TO PARTICIPATE IN SUCH ACTIVITY. I HEREBY RELEASE, DISCHARGE, COVENANT NOT TO SUE, AND AGREE TO INDEMNIFY, SAVE AND HOLD HARMLESS EACH OF THE RELEASEES FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON THE MINOR'S ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE "RELEASEES" OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS AND FURTHER AGREE THAT IF, DESPITE THIS RELEASE, I, THE MINOR, OR ANYONE ON THE MINOR'S BEHALF MAKES A CLAIM AGAINST ANY OF THE RELEASEES NAMED ABOVE, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES FROM ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS LIABILITY, DAMAGE OR COST ANY MAY INCUR AS THE RESULT OF SUCH CLAIM.
PRINTED NAME OF PARENT/GUARDIAN:________________________________________________ ADDRESS:________________________________________________________________________ (Street) (City) (State) (Zip) PHONE:_____________________________ PARENT/GUARDIAN SIGNATURE:______________________________________________________ (only if participant is under the age of 18) DATE:____________________________
THE NATIONAL CAPITAL BICYCLE TOUR REQUIRES ALL RIDERS TO WEAR HELMETS!