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Group Therapy Bike Tours Liability Waiver

Group Therapy Bike Tours- Release of Liability and Assumption of Risk

In consideration of the services of Group Therapy Bike Tours, their agents, owners, ofcers, volunteers, participants, employees and all other persons or entities acting in any capacity on their behalf (hereinafter collectively referred to as Group Therapy Bike Tours)I hereby agree to release and discharge Group Therapy Bike Tours, on behalf of myself, my children, my parents, my heirs, assigns, personal representative and estate as follows:

 

1. I acknowledge that the activities involved in the use of any Group Therapy Bike Tours service, both riding and pedaling, and non-riding and non-pedaling related, entail signicant risks, both known and unknown, which could result in physical or emotional injury, paralysis, death, or damage to myself, to property, or third parties.

 

2. I expressly agree and promise to accept and assume all of the risks existing in this activity, both known and unknown , whether caused or alleged to be caused by the negligent acts or omissions of Group Therapy Bike Tours or its operators. My participation in this activity is purely voluntary and I elect to participate in spite of the risks.

 

3. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless Group Therapy Bike Tours from any and all claims, demands, or causes of action, which are in any way connected with my participation in this activity or my use of Group Therapy Bike Tours' equipment and facilities, including any such claims which allege negligent acts of omissions of Group Therapy Bike Tours.

 

4. Should Group Therapy Bike Tours or anyone acting on their behalf, be required to incur attorneys fees as a cost to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs.

 

5. I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating, or else I agree to bare the cost of such injury or damage myself. I further certify that I have no medical or physical conditions which could interfere with my safety in this activity, or else I am willing to assume and bear the costs of all risks that may be created, directly or indirectly, by any such condition.

 

6. I agree that the validity and enforceability of this Release of Liability and Assumption of Risk will be governed by the substantive law of Nebraska, including the Recreation Safety Act, without regard to its conict of law rules.

 

7. I agree to abide by any and all of the rules set forth by the owners and operators of Group Therapy Bike Tours. By signing this document, I acknowledge that if anyone is hurt or property is damaged durning my participation in this activity, I may be found by a court of law to have waived my right to maintain a lawsuit against Group Therapy Bike Tours on the basis of any claim from which I have released them herein.

 

8. I expressly understand that I can and will be held financially responsible for any physical damage, and loss of business revenue, if I or anyone in my group damages property owned by Group Therapy Bike Tours in any manner.

 

9. I understand that the operators of Group Therapy Bike Tours, including its' Owners and Drivers, may terminate my Group Therapy Bike Tours tour at any time if it is determined that my group is acting in an inappropriate manner, including but not limited to signs of intoxication, littering, vulgar language, excessive noise and acting in a manner that is unsafe to myself, my fellow passengers and members of the public.

10. I hereby assign full copyright of photographs and video to Group Therapy Bike Tours with the right of reproduction either wholly or in part. I grant to the Photographer or licensees or assignees the permission to can the above-mentioned photographs either separately or together, either wholly or in part, the perpetual and irrevocable and unrestricted right to use and publish video and/or photographs of me, or where I may be included for editorial trade, product advertising and such other fashion /business purpose in any manner and medium. The Photographer and licensees or assignees may have unrestricted use of these for whatever purpose, including advertising, with any retouching or alteration without restriction. I agree that the above mentioned photographs and any reproductions shall be deemed to represent an imaginary person, and further agree that the Photographer or any person authorized by or acting on his or her behalf may use the above mentioned photographs or any reproductions of them for any advertising purposes or for the purpose of illustrating any wording, and agree that no such wording shall be considered to be attributed to me personally unless my name is used. Provided my name is not mentioned in connection with any other statement or wording which may be attributed to me personally, I undertake not to Prosecute or to institute proceedings, claims or demands against either the Photographer or his or her agents in respect of any usage of the above mentioned photographs. I hereby release the photographer named above from all claims and liability relating to images, video or photographs taken of me. I have read this model release form carefully and fully understand its meanings and implications.

NO REFUND will be provided if your tour is cancelled as a result of the above activity.

 

I HAVE HAD SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE READ AND UNDERSTAND IT AND I AGREE TO BE BOUND BY ITS TERMS.

 

 

Parents or Guardians Additional Indemnication

(Must be completed for participants under the age of 18)

 

In consideration of the minor listed below (Minor) being permitted by Group Therapy Bike Tours to participate in its activities and to use its equipment and facilities, I further agree to indemnify and hold harmless Group Therapy Bike Tours of any and all claims which are brought by, or on behalf of Minor, and which are in any way connected with such use or participation by Minor.

 

 

 



First Group Therapy Patient's Name

First Name*

Last Name*
First Group Therapy Patient's Date of Birth*
First Group Therapy Patient's Signature*
Second Group Therapy Patient's Name

First Name*

Last Name*
Second Group Therapy Patient's Date of Birth*
Third Group Therapy Patient's Name

First Name*

Last Name*
Third Group Therapy Patient's Date of Birth*
Fourth Group Therapy Patient's Name

First Name*

Last Name*
Fourth Group Therapy Patient's Date of Birth*
Fifth Group Therapy Patient's Name

First Name*

Last Name*
Fifth Group Therapy Patient's Date of Birth*
Sixth Group Therapy Patient's Name

First Name*

Last Name*
Sixth Group Therapy Patient's Date of Birth*
Seventh Group Therapy Patient's Name

First Name*

Last Name*
Seventh Group Therapy Patient's Date of Birth*
Eighth Group Therapy Patient's Name

First Name*

Last Name*
Eighth Group Therapy Patient's Date of Birth*
Ninth Group Therapy Patient's Name

First Name*

Last Name*
Ninth Group Therapy Patient's Date of Birth*
Tenth Group Therapy Patient's Name

First Name*

Last Name*
Tenth Group Therapy Patient's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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