June 21, 2008
Sponsored by the Rotary Club of Kernersville, NC

SAVE THE DATE……June 13, 2009…
2nd Annual Pedal the Piedmont
 
 
WAIVER
 
 

WAIVER (Your registration will NOT be processed unless this is signed)

In consideration of being allowed to participate in any way in Pedal the Piedmont related events and activities, the undersigned acknowledges, appreciates and agrees that:

1. The risk of injury from the activities involved in Pedal the Piedmont is significant, including the potential for permanent paralysis and death; and,
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; and, I further understand that obedience of traffic regulations and signal devices is my responsibility; and,
3. I willingly agree to comply with the stated and customary terms and conditions for participation. If however, I observe any unusual significant hazard during my participation, I will remove myself from participation and bring such to the attention of the nearest Pedal the Piedmont representative; and,
4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, hereby release and hold harmless Pedal the Piedmont, their officers, officials, agents, and/or employees, volunteers, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event. I understand and agree that the sponsors make no warranties what so ever and are not responsible for one’s safety during Pedal the Piedmont or while traveling to and from Pedal the Piedmont.
5. I grant to Pedal the Piedmont my permission to use without charge any and all photographs, video reproductions or other like kinds of image productions taken during the event.
6. I understand that I can be removed from the ride at any time for any reason with no refund.
7. I acknowledge that my registration fee is non-refundable if I choose not to participate.

 

X_______________________________________________ Signature Date: _______________________

Printed Name of Participant. *Parent or legal guardian must sign if participant is under 18 years of age.

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