2014 TOUR DE SHULS CONNECTICUT
LIABILITY WAIVER and ASSUMPTION of RISK
I understand that my consent to these provisions is given in consideration of
the acceptance of this registration and for me and/or the minor child(ren) named
below (the “child(ren)”) being permitted to participate in this event. I am eighteen
years of age or older and/or the parent or legal guardian of the child(ren).
I certify that I and/or the child(ren) am a voluntary participant in this event,
and in good physical condition. I understand that bicycle riding, participating in a
bicycle ride on public roads and participating in this event is a potentially
hazardous and dangerous activity with many different risks. I fully assume the
risks associated with my and/or the child’s(ren’s) participation. These risks include
but are not limited to the dangers of collisions with pedestrians, vehicles, other
riders, and fixed or moving objects; the dangers of surface hazards, equipment
failure, inadequate safety equipment, weather conditions; and the potential of
serious physical and mental injury.
I hereby assume full and complete responsibility for any injury, damage,
misadventure, harm, loss, inconvenience and/ or accident(s) which may occur
during my and/or the child’s(ren’s) participation in this event, the activity of
bicycle riding and/ or while on the premises of this event, and I, on behalf of
myself and/or the child(ren), hereby release, indemnify and hold harmless and
covenant not to file suit against the Connecticut Valley Region of the Federation
of Jewish Men's Clubs (dba Tour de Shuls Connecticut), all Participating Shuls,
and all involved municipalities, their officers, employees, organizers, volunteers,
sponsors their trustees, directors, agents and any affiliated individuals; and all
other persons and/or entities associated with this event (the “releasees”) from any
loss, liability, injuries, damage, misadventure, harm, inconvenience or claims
whatsoever (whether such loss, liability, harm, injury and/or damage be known or
unknown), including attorney’s fees in any matters arising out of or resulting from
and/or in connection with my and/or the child’s(ren’s) participation in this event,
the activity of bicycle riding, personal injury or damage suffered by me and/or the
child(ren) or others, whether same be caused by falls, contact with other
participants/objects, conditions of the course, dangers of collision, equipment
failure, inadequate safety equipment, weather conditions, negligence of the
releases or otherwise.
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I shall abide by all traffic laws and practice courtesy and safety in cycling. I
and/or the child(ren)have been advised to wear a helmet during participation in the
Tour De Shuls and I/we agree to do so. If I and/or the child(ren) do not follow all
the rules of this event, I understand that I and/or the child(ren) may be removed
from the ride or walk.
I understand and agree that I am expected to have my own health and
accident insurance coverage in the event of any injury or loss that occurs during
the Tour.
I further understand and agree that the foregoing indemnity, release and
waiver is intended to be as broad and inclusive as permitted by the laws of the
State of Connecticut, and that if any portion thereof is held invalid, it is agreed that
the balance shall, notwithstanding, continue in full force and effect.
I give my full permission to the Tour de Shuls the event sponsors and their
agents, representatives and assigns to use my and/or the child’s (ren’s)
photographs, videotapes, images, audio and/or other recordings of me and/or the
child(ren) that are made during the course of the event.
If taking part in the bike ride - I certify that the child(ren) is under the age of
eighteen years old.
I have read the foregoing carefully and understand its contents and
implications, and have signed of my own free act.
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Parent
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Date
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Minor
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Date
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