Loading...

Participant's Full Waiver, Release, Warranty and Agreement

 

FORMAL RELEASE OF ANY AND ALL LIABILITY

I fully assume all risks associated with my participation in the event. Further, I fully release and discharge without limitation The Fuller Center for Housing, Inc. and their employees, directors, agents, volunteers, officers, co-ventures, and partners ("FCH") from any and all actions, claims, or demands for damages or any other form of relief of any type, whether known or unknown, present or future, and regardless of the legal theory or claim for relief, that in any respect arise from or in any way connect with my participation in any Fuller Center Bicycle Adventure event(s) ("FCBA" or "Event"). The foregoing release and discharge is binding upon me personally, my agents, any sponsors, assigns, my medical providers, heirs, executors/administrators, family members and any person or entity with any form of interest in my estate. I covenant not to bring any form of claim or action against FCH or FCBA for a matter having any form of connection with the Event. I further specifically release FCH and FCBA for any acts of negligence in connection with the Event. I expressly agree that this Release is intended to be as broad and inclusive as permitted by the laws of the states of my residence and Georgia, and that this Release shall be governed by and interpreted in accordance with the laws of the State of Georgia.

I understand that my participation in the FCBA is a potentially hazardous activity that can result in serious bodily injury, including permanent disability, paralysis, and death from a wide variety of matters that may arise in connection with the Event, known and unknown, predictable and unpredictable, and that injury and illness (including but not limited to COVID-19) can result to me and others from matters in connection with the Event. 

I agree to wear a helmet at all times and use reflective mirrors or lights or other visual-enhancement-during-darker-hours equipment while cycling during the FCBA. I will not use or consume alcohol or any other impairing substance in such a timing or manner that it would lessen my safey during the Event. I further agree to follow, to the best of my ability, all of the safety policies of the FCBA and understand that failing to follow these policies could result in my immediate dismissal from the event without refund or compensation.  

I understand that FCH reserves the unlimited right in its sole discretion to deny or cease my participation in a FCBA event at any time before or during the trip. In exercising its unlimited discretion to refuse or cease participation, FCH will consider the following grounds: inaccurate or incomplete applications; failure to meet the fundraising requirements or deadlines; skills, physical or medical conditions that may affect effective participation; violation of any FCH and FCBA conduct policy; diagnosis of COVID-19 or failure to follow COVID-19 protocols or requirements; disrespect shown to the leaders of the FCBA; behavior deemed by FCBA in its sole discretion to be dangerous or detrimental to myself or other participants or any other way detrimental to the best interests of FCH, FCBA and the event. I further understand that in the case of my withdrawal or expulsion from the trip, my fundraising balance and registration fee will be considered a donation to FCH and will not be refunded.


I agree that I will not participate in the FCBA unless I am medically able to do so and unless I am properly trained.

I warrant to FCH and FCBA that I am medically able, and properly trained, that I know how to perform basic skills in participating in the Event (including but not limited to, operating bicycle gears, brakes, seat adjustments, quick releases, performing repairs to my bicycle in the event of damage that may occur during the Event, the rules of the road, and proper bicycle etiquette). I warrant that I am aware of and assume all risk associated with bicycling, including but not limited to injuries or death related to falling, collision, psychological issues, slick pavement, broken traffic laws, actions or lack of action by other cyclists or motorists, personal inexperience or ability, improper or inaccurate instructions from trip leaders, and other risks or causes of injury. I accept the risk that other Event participants and FCH or FCBA actors may not have some skills or knowledge and that I can be injured as a result.

I understand that FCH and the FCBA do not certify that the provided bicycling routes include roads suitable for bicycling, and that the decision to bicycle on those roads is my own.

I understand that the FCBA is not just a bicycling event, but there are other risks that might be associated with my participation, including but not limited to risks related to volunteer work projects with FCH or its partner organizations, improperly cooked food, injury resulting from cooking or from being in proximity with others cooking, and injury or death from driving or being driven in motor vehicles. I assume and am responsible for all risk, as set forth above, associated with the FCBA.

I understand that I need to have my own health insurance while on the trip. I further agree to undergo any needed or recommended medical treatment in the event of accident, illness or medical condition during a FCBA event. I also agree to undergo or self-perform any Covid-related tests or temperature checks required by the event, and to allow FCH and FCBA to share the results of those tests with any interested parties, including riders, hosts and volunteers. It is my responsibility to inform FCH of any changes in my medical condition before the tour begins. Failure to meet any of the above conditions may result in my dismissal from the trip.

I understand that FCH reserves the right to restrict my participation if deemed to be unsafe or medically inappropriate, but that FCH is not responsible for determining whether or not I am fit to participate. I warrant that I am medically able to participate in the FCBA and that I am unaware of any medical condition that could potentially limit my participation. I agree that I will not participate unless I am medically able to do so, and I understand that the responsibility for determining whether I am in condition to participate falls upon me, not FCH. 

I understand that there is a minimum fundraising requirement in order to participate in the event. If any shortfall remains as of the time I depart the event, I authorize The Fuller Center for Housing to charge my credit card or bank account the balance of any unmet fundraising requirement plus cover the processing costs (4% for credit card, 2% for bank accounts).

I further hereby grant full, unconditional and liability-free permission to FCH, FCBA and its volunteers and representatives to transport myself, any bicycle and other valuables in my possession before, during, or after the Event. I hereby release, defend, indemnify and hold harmless FCBA from and against any claims, damages or liability arising from or related to the transportation of myself or the bicycle(s) and other valuables, including but not limited to injuries, death, cuts, dings, scratches, scuffs, abrasions, dents, marring, damages to the frame, damages to the components, damages to the wheel(s) and/or tire(s), damages to the handlebars, damages to the seat, damages to the braking system, and other mechanical or cosmetic damages.

I waive any right to seek compensation of damages, whether minor or major, for the bicycles and other valuables resulting from the negligence, incidental actions, and/or direct actions of FCBA and its representatives. This applies to all cases and means of transportation by FCBA, whether by vehicle or by-hand, and whether by means of adherence to a bicycle rack or by other means. 

In addition, I hereby grant and convey unto FCH and the Event all right, titles, and interest in any writing, picture, or audio/video recording made by or in connection with FCH or the Event, to be used as the Event and FCH sees fit, including but not limited to any royalties, proceeds, or other benefits derived from such writings, pictures, or recordings.


I consent to allow the use of an electronic signature and electronic transmission of this agreement. I agree not to deny the legal effect or enforceability of this agreement solely because it is in electronic form or was transmitted electronically or because it is not in its original form as an original document.

I have read, understand, and agree to the above statement.

I HAVE CAREFULLY READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE VOLUNTARILY AND WITHOUT DURESS GIVEN UP SUBSTANTIAL RIGHTS BY AGREEING TO IT AND HAVE AGREED TO 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.

I WARRANT I AM NOT UNDER THE INFLUENCE OF ANY IMPAIRING SUBSTANCE WHILE SIGNING THIS AGREEMENT AND THAT I WILL NOT USE OR CONSUME ANY IMPAIRING SUBSTANCE BEFORE RIDING MY BICYCLE OR DRIVING A MOTORIZED VEHICLE DURING THE EVENT.


First Participant's Name

First Name*

Middle Name

Last Name*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's Signature*
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Signature*
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Signature*
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Signature*
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Signature*
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Signature*
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Signature*
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Signature*
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Signature*
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*

Middle Name

Last Name*

Relationship*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!