I (or if the participant is under 18 years of age, I as parent/legal guardian on the child’s behalf), hereby unconditionally release, waive and discharge the Rotary Club of Greater Rochester, its members, officers, event sponsors, organizers, agents, and all event volunteers (collectively, the “Released Parties”) from any and all claims, liabilities, losses, demands and actions which I or my heirs, executors, or assigns may have or which may hereafter accrue with respect to any and all loss, damage or injury, including death, and damage to any personal property, caused by or arising out of, or in any way related to, my participation in the Believe In Me Greater Rochester Rotary Bike Ride, whether caused wholly or in part by the negligence of any of the Released Parties.
I acknowledge the inherent dangers involved in bicycling. I knowingly assume the risk of injury, harm and loss associated with my participation in the Believe In Me Greater Rochester Rotary Bike Ride.
I hereby consent to having my picture taken in connection with the Believe in Me Greater Rochester Rotary Bike Ride. I give the Released Parties, their successors and assigns, the right to use, reproduce or distribute my photograph and video or audio recordings of or including my image or voice, for educational, publication or marketing purposes without compensation to me. I waive any right to inspect or approve any proposed publication, in any medium. I waive any rights and release the Released Parties from any claims or causes of action I have to object to, prevent or seek damages for the release, publication or use of my images or audio.
I have read this Release and Waiver of Liability, understand all its terms, and sign it voluntarily. I am at least 18 years of age and am competent to sign this Release and Waiver of Liability. If the participant is under 18 years of age, I assert that I am the parent/legal guardian of the participant child and that I am authorized to execute this Release and Waiver of Liability on behalf of the participant child. If under 18 years of age, this Release and Waiver of Liability and the registration form must be signed by the parent/legal guardian of the participant.
If you are registering on-line, your electronic signature is the online equivalent of your ink-on-paper signature, and can be provided by typing your name where indicated. The electronic signature will signify your understanding, acceptance, and authorization to accept the conditions set forth in this Release and Waiver of Liability.
Printed Name of Participant: _______________________________
Printed Name of parent/legal guardian (if participant under age 18): ________________________
Participant’s Date of Birth: _________________
Participant’s Address and Phone number: ______________________________