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Skyline Membership Application
Skyline Cycling Club
Membership Application
Name:__________________________________________________________________
(List all members included in your membership)
Address:_________________________________________________________________
(include City, State, Zip, Apt.)
Home Telephone: (______)_______________________
Work Telephone: (______)_______________________
E-Mail:______________________________________________________
(optional)
I would like to join the Skyline Yahoogroup E-list using this email address:______________________________________________________
(optional)
Read and Sign the Following Release of Liability
Agreement
LEAGUE OF AMERICAN WHEELMEN d/b/a LEAGUE OF AMERICAN
BICYCLISTS ("LAB") RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF
RISK, AND INDEMNITY AGREEMENT ("AGREEMENT")
IN CONSIDERATION of being permitted to participate in any way in the
Skyline Cycling Club ("Club") sponsored Bicycling Activities
("Activity") I for myself, my personal representatives, assigns,
heirs, and next of kin:
1. ACKNOWLEDGE, agree, and represent that I understand the nature of
Bicycling Activities and that I am qualified, in good health, and in
proper physical condition to participate in such Activity. I further
acknowledge that the Activity will be conducted over public roads and
facilities open to the public during the Activity and upon which the
hazards of travelling are to be expected. I further agree and warrant
that at any time I believe conditions to be unsafe, I will immediately
discontinue further participation in the Activity.
2. FULLY UNDERSTAND that: (a) BICYCLING ACTIVITIES INVOLVE RISKS AND
DANGERS OF SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY,
PARALYSIS AND DEATH ("RISKS"); (b) these Risks and dangers may be
caused by my own actions or inactions, the actions or inactions of
others participating in the Activity, the condition in which the
Activity takes place, or THE NEGLIGENCE OF THE "RELEASEES" NAMED
BELOW; (c) there may be OTHER RISKS AND SOCIAL AND ECONOMIC LOSSES
either not known to me or not readily foreseeable at this time; and I
FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBLITY FOR
LOSSES, COSTS, AND DAMAGES I incur as a result of my participation in
the Activity.
3. HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE the Club, the
LAB, their respective administrators, directors, agents, officers,
volunteers, and employees, other participants, any sponsors,
advertisers, and, if applicable, owners and lessers of premises on
which the Activity takes place, (each considered one of the
"RELEASEES" herein) FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR
DAMAGES ON MY 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 I FURTHER AGREE that if, despite this
RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY
AGREEMENT I, or anyone on my behalf, makes a claim against any of the
Releasees, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE
RELEASEES from any litigation expenses, attorney fees, loss,
liability, damage, or cost which may incur as result of such claim.
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 LAB AND AGREE THAT IF ANY PORTION OF
THIS AGREEMENT IS HELD TO BE INVALID THE BALANCE, NOTWITHSTANDING,
SHALL CONTINUE IN FULL FORCE AND EFFECT.
_____________________________________________________________
Date and Signature
_____________________________________________________________
Date and Co-applicant Signature or
Parent Signature (if member is under 18)
You must be 18 years old or older, or be accompanied by a parent or guardian,
to ride with Skyline Cycling Club.
Annual Dues
| Single |
$14.00 |
| Couple |
$20.00 |
| Full-time College Student |
$8.00 |
Enclosed is my check in the amount of $ _________________
Make check payable to: Skyline Cycling Club
Mail to:
Skyline Cycling Club
P.O. Box 60176
Sunnyvale, CA 94088
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