BUC BIKE – DAILY CHECK-OUT
USE LOG AND WAIVER
As a part of the Buc Bikes program, the “Yellow Bikes” are refurbished bikes that have been
donated or left in surplus by former students. The bikes all come with a lock and helmet. This is
a RIDE AT YOUR OWN RISK service. Before you can check-out a “Yellow Bike” you must read,
agree to and sign the Informed Consent, Acknowledgement of Risk and Assumption of Liability
Form on the back of this page.
Buc Bikes Daily Use Policies
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Riders must abide bide by all local and state traffic laws.
Riders must check the bike for safe operation before using.
Riders must wear a helmet at all times while riding the bike.
Rider is responsible for filing a report with Public Safety for any stolen bike or accessories.
The daily use Buc Bikes must be returned during normal operating hours to the
location where the bike =was checked out. Long term or overnight use is not
permitted.
Fees
Late fees and replacement/damage fees will be charged to the borrower if the bike, lock/key and
helmet are not returned or are returned damage; $2/day late fee, $15 lock/key, $25 helmet,
$100 bike
*Buc Bike users are financially responsible for replacement fees for damages or theft and
penalties for late fees. Overdue fees will result in a hold will be placed on accounts,
administrative discipline, and a loss of program privileges.
I have read and understand the Buc Bike Program safety guidelines and fees for bikes
returned late, damaged or not returned, and assume all responsibility while using this
service. I understand that it is my responsibility to know and follow all Tennessee and
Johnson City bicycle laws. Initial: _____
________________________________
Print Name
_____________________________________
E-mail address
________________________________
Sign Name
________________
ETSU E #
_________________
Phone #
Cleaner. Healthier. Cheaper. Faster!
6/23/14DM
Informed Consent, Acknowledgement of Risk, Assumption of Liability
I am aware and understand that participating in _Bike Riding_ involves a potential risk of
physical injury and death. I understand that the activity is physically demanding and potentially
dangerous. I agree and hereby state that I am solely responsible for my own participation and for my own
physical and emotional well-being. I am aware and understand that participation is strictly voluntary and
it is my own choice to participate. After due consideration of my own physical health, physical abilities
and mental condition, I further state that in choosing to participate, I am not under the influence of any
chemical substance including alcohol. I willingly and knowingly assume for myself, my heirs, family
members, executors administrators and assigns all risk of physical and emotional injury which may occur
during or after participating in any aspect of the program and hereby agree to hold the State of Tennessee,
East Tennessee State University, Tennessee Board of Regents, its employees, its instructors, facilitators,
volunteers and agents harmless for any liability arising out of my participation in the program. Should
E.T.S.U. or anyone acting on their behalf be required to incur attorney’s fees and costs to enforce this
agreement, I agree to indemnify (to assume the responsibility for payment of damages to someone else)
and hold E.T.S.U. harmless for all such fees and costs. This release does not, however, apply to any
physical injury or emotional harm caused by negligence or willful misconduct of E.T.S.U. its employees,
its instructors, facilitators and agents.
East Tennessee State University assumes no responsibility for injuries received during Campus
Recreation programs. All participants are reminded that participation is completely voluntary. It is
strongly recommended that all participants have a physical examination and secure adequate medical
insurance prior to participation. I understand that ETSU has no blanket insurance and I assume all
financial responsibility for all medical treatment.
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.
_______________________________
Name (please print)
________________________________
Signature
Date
Bike
#
6/23/14DM
Time Checked
Out
______________________________
Date
Time Checked
In
Saff
Initials
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