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CycleSaloon Release of Liability Waiver

Today's Date: May 24, 2018

CYCLESALOON RIDER RELEASE OF LIABILITY:

I affirm that I am at least twenty-one years of age.
I understand that operating the CycleSaloon is a potentially dangerous activity.
I understand that I may be injured or may injure someone else while using the CycleSaloon.

I assume the risk that I may be injured and/or injure someone else while using the CycleSaloon.
I assume all risks associated with my use of the CycleSaloon and will not bring any action against CycleSaloon, its successors and/or assigns, for personal injury, property loss, or property damage, including any action for negligence, breach of warranty, products liability or strict liability.

The CycleSaloon is of proprietary manufacture, and I agree not to build or cause to be built any vehicle of the same or similar construction.

I further agree to release, indemnify and hold harmless the owners and manufacturers of the CycleSaloon from any liability against any and all claims, including damages or demands of third parties resulting directly or indirectly from my actions without limitation as a result of my use of the CycleSaloon.

I also agree that CycleSaloon is not responsible for the conduct of other persons or the conditions of any biking surface.

I have read, understood, and I agree to the above provisions.

First Rider's Name

First Name*

Last Name*

Phone*
First Rider's Date of Birth*
First Rider's Information

Mobile Phone/Hotel
I decline the offer of the free use of a helmet while riding the CycleSaloon.

Date of Reservation:*
First Rider's Signature*
Second Rider's Name

First Name*

Last Name*
Second Rider's Date of Birth*
Second Rider's Information

Mobile Phone/Hotel
I decline the offer of the free use of a helmet while riding the CycleSaloon.

Date of Reservation:*
Third Rider's Name

First Name*

Last Name*
Third Rider's Date of Birth*
Third Rider's Information

Mobile Phone/Hotel
I decline the offer of the free use of a helmet while riding the CycleSaloon.

Date of Reservation:*
Fourth Rider's Name

First Name*

Last Name*
Fourth Rider's Date of Birth*
Fourth Rider's Information

Mobile Phone/Hotel
I decline the offer of the free use of a helmet while riding the CycleSaloon.

Date of Reservation:*
Fifth Rider's Name

First Name*

Last Name*
Fifth Rider's Date of Birth*
Fifth Rider's Information

Mobile Phone/Hotel
I decline the offer of the free use of a helmet while riding the CycleSaloon.

Date of Reservation:*
Sixth Rider's Name

First Name*

Last Name*
Sixth Rider's Date of Birth*
Sixth Rider's Information

Mobile Phone/Hotel
I decline the offer of the free use of a helmet while riding the CycleSaloon.

Date of Reservation:*
Seventh Rider's Name

First Name*

Last Name*
Seventh Rider's Date of Birth*
Seventh Rider's Information

Mobile Phone/Hotel
I decline the offer of the free use of a helmet while riding the CycleSaloon.

Date of Reservation:*
Eighth Rider's Name

First Name*

Last Name*
Eighth Rider's Date of Birth*
Eighth Rider's Information

Mobile Phone/Hotel
I decline the offer of the free use of a helmet while riding the CycleSaloon.

Date of Reservation:*
Ninth Rider's Name

First Name*

Last Name*
Ninth Rider's Date of Birth*
Ninth Rider's Information

Mobile Phone/Hotel
I decline the offer of the free use of a helmet while riding the CycleSaloon.

Date of Reservation:*
Tenth Rider's Name

First Name*

Last Name*
Tenth Rider's Date of Birth*
Tenth Rider's Information

Mobile Phone/Hotel
I decline the offer of the free use of a helmet while riding the CycleSaloon.

Date of Reservation:*
11 Rider's Name

First Name*

Last Name*
11 Rider's Date of Birth*
11 Rider's Information

Mobile Phone/Hotel
I decline the offer of the free use of a helmet while riding the CycleSaloon.

Date of Reservation:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Send me special offers and discounts via SMS or 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.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Mobile Phone/Hotel
I decline the offer of the free use of a helmet while riding the CycleSaloon.

Date of Reservation:*
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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