Znamy datę IV Międzystanowej Pielgrzymki Rowerowej !!! ∗∗∗∗ Odbędzie się 15-21 Lipca 2019!!!
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RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT ("Agreement") for

NAROWERZE CYCLING PILGRIMAGE TO AMERICAN CZESTOCHOWA IN THE UNITED STATES   ("NAROWERZE")

                                      (This form is to only be used for Individual Adults)

IN CONSIDERATION of being permitted to participate in any way in Narowerze Cycling Pilgrimage to American Czestochowa in the United States ("Cycling Activity/Cycling Event") 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 traveling are to be expected. I further agree and warrant that if, 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 conditions 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 RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I may incur as a result of my participation in the Activity.

 

3. HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE the Organizers of the Cycling Activity, The Cycling Event, its respective administrators, directors, agents, officers, members, volunteers, and employees, other participants, any sponsors, advertisers, and, if applicable, owners and lessors 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 any may incur as the result of such claim.

 

I AM 18 YEARS OF AGE OR OLDER, HAVE READ AND UNDERSTAND THE TERMS OF THIS AGREEMENT, UNDERSTAND THAT I AM GIVING UP SUBSTANTIAL RIGHTS BY SIGNING THIS AGREEMENT, HAVE SIGNED IT VOLUNTARILY 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. I AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID, THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT.

By signing this agreement I also acknowledge that I will follow all rules and regulations of the public road and any/all safety precautions conveyed to me by the organizers of the Cycling Activity including but not limited to:

  • I agree to wear a helmet at all times I am riding my bicycle during this Cycling Event;
  • I agree to ride as a group, watch for problems (loose straps, loose equipment), and help my fellow cyclists have a safe and enjoyable ride;
  • I agree to use hand and verbal signals to communicate with members of the group and with other traffic (hand signals for turning and stopping are as follows: Left are straight out to signal a left turn. Left arm out and down with you palm to the rear to signal slowing or stopping. And, for a right turn, put your right arm straight out (in areas where this is legal) or put your left arm out and bent up.
  • I agree to use verbal warnings to warn my fellow riders of any potential road hazards or maneuvers I am making;
  • I agree to watch for traffic coming from the rear;
  • I agree to verify the way is clear before entering an intersection;
  • I agree to move off the road if I am stopping for any reason;
  • I agree to Ride single file or double file as appropriate to the roadway and traffic conditions and where allowed by law. Even where riding double is legal, courtesy dictates that I will single up when cars are trying to pass me if the lane is wide enough for them to safely do so;
  • I agree to follow all instructions and directions of the group leader (the bike groups will be divided into groups of 15-20 cyclists so that there are no more than 20 cyclists in a given section of the road at a given time, the groups will stick together and no member of a bicycle group shall be left behind); 
  • I agree to stay on the roads designated by the group leader;
  • I shall not consume alcoholic beverages or drugs while involved in this cycling event;
  • I will be respectful to fellow group members and group leaders(If I do not abide by these instructions or instructions given to me by the group leader I will be asked to leave the bicycle event); 
  • I will follow all rules of the road;

PARTICIPANT’S NAME (PRINTED):______________________________________________

PARTICIPANT’S SIGNATURE: __________________________________________________

ADDRESS: ___________________________________________________________________

                                    (Street)                                        (City)                (State)                   (Zip)

PHONE: (__________)___________________________            

EMERGENCY CONTACT NAME: _______________________________________________

EMERGENCY CONTACT PHONE NUMBER: ______________________________________

Date: _________________

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