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Boulder Valley Cycling Alliance dba Boulder Junior Cycling

RELEASE OF LIABILITY AND ASSUMPTION OF RISK – READ BEFORE SIGNING

Boulder Valley Cycling Alliance dba Boulder Junior Cycling

Release of Liability, Assumption of Risk, Photography Release, & Medical Authorization

READ CAREFULLY BEFORE SIGNING.

In consideration of allowing me or my minor child (as the case may be), who is the “Participant”, to participate in any way with the Boulder Valley Cycling Alliance dba Boulder Junior Cycling (“BVCA/BJC”) programs, its related events and all activities, I acknowledge and agree to the following:

1.) The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular skills, equipment and personal discipline may reduce this risk, the risk of serious injury does exist. I agree and understand that biking is a HAZARDOUS activity with varying surface and environmental conditions. I recognize that falls and collisions with pedestrians, other bike riders and vehicles do occur and I assume all risks and responsibility for such incidents and injuries. 

Participation includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist.

2.) I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation.

3.) I believe Participant is in good health and in proper physical condition to participate in all BVCA/BJC activities and that such participation will in no way aggravate any medical condition(s) present. I understand that I am responsible for consulting a physician concerning the health and fitness of Participant and Participant’s ability to participate in all BVCA/BJC activities.

4.) I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY WAIVE AND RELEASE all claims against, and agree to INDEMNIFY AND HOLD HARMLESS, BVCA/BJC, their coaches, directors, officers, officials, agents, employees, volunteers, other participants, sponsors, advertisers, and if applicable, owners and lessors of any premises used for the activities (collectively, the “Releasees”), WITH RESPECT TO ANY AND ALL LOSSES, DAMAGES, LIABILITY, CLAIMS, SUITS OR ACTIONS, JUDGMENTS, COSTS OR EXPENSES DUE TO INJURY, DISABILITY, DEATH, OR OTHER loss or damage to person or property associated with my presence or participation, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

5.) I hereby grant to BVCA/BJC permission to take or have taken still and moving photographs and films and consent and authorize BVCA/BJC to use and reproduce the photographs, films or pictures and to circulate and publicize the same by all means, including but not limited to, BVCA/BJC’s website, news, internet, brochures and pamphlets, and social media.

6.) If, in the judgment of any of BVCA/BJC 's coaches or other adult representatives, Participant needs immediate care and treatment as a result of any injury or illness, I do hereby request, authorize and consent to such care and treatment as may be given to Participant by any physician, coach, nurse, consent to such care and treatment as may be given to Participant by any physician, coach, nurse, hospital or BVCA/BJC representative.

I have read this Release of Liability and Assumption of Risk Agreement, the Photography Release and the Medical Authorization and fully understand its terms. I understand that I have given up substantial rights by signing it, and I sign it freely and voluntarily without any inducement.

Please Note: In the event that Participant is a minor (under the age of 18), parent/guardian electronic signature required.

First Participant(s) Name

First Name*

Last Name*
First Participant(s) Date of Birth*
First Participant(s) Signature*
Second Participant(s) Name

First Name*

Last Name*
Second Participant(s) Date of Birth*
Third Participant(s) Name

First Name*

Last Name*
Third Participant(s) Date of Birth*
Fourth Participant(s) Name

First Name*

Last Name*
Fourth Participant(s) Date of Birth*
Fifth Participant(s) Name

First Name*

Last Name*
Fifth Participant(s) Date of Birth*
Sixth Participant(s) Name

First Name*

Last Name*
Sixth Participant(s) Date of Birth*
Seventh Participant(s) Name

First Name*

Last Name*
Seventh Participant(s) Date of Birth*
Eighth Participant(s) Name

First Name*

Last Name*
Eighth Participant(s) Date of Birth*
Ninth Participant(s) Name

First Name*

Last Name*
Ninth Participant(s) Date of Birth*
Tenth Participant(s) Name

First Name*

Last Name*
Tenth Participant(s) Date of Birth*
Parents/Guardians Email Address

Email*

Confirm Email*
FOR PARENTS/GUARDIANS OF PARTICIPANTS OF MINORITY AGE This is to certify that I, as parent/guardian with legal responsibility for the participant(s) listed above, do consent and agree to his/her release as provided above of all the Releasees, and, for myself, my spouse, my child and our heirs, assigns and next of kin, I waive, release and agree to indemnify and hold harmless the Releasees from any and all losses, damages, liability, claims, suits or actions, judgments, costs and expenses due to injury, disability, death, or other loss or damage relating to or arising from my minor child’s involvement or participation in these programs as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law.


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.
Parents/Guardians Name

First Name*

Last Name*
Parents/Guardians Date of Birth*
Parents/Guardians 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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