Greater Eugene Area RiderS Membership Application
Name: Under_18_years:Y/N
Street Address: City: State: Zip:
Phones: (Home) (Work) Day.. / ..Night
OK to publish phone in Club directory? Y / N - Email Address:

READ AND SIGN THE FOLLOWING RELEASE OF LIABILITY: - LEAGUE OF AMERICAN BICYCLISTS (“LAB”) RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT (“AGREEMENT”)

IN CONSIDERATION of being permitted to participate in any way in the Greater Eugene-Area Riders Cycling Club (“Club”) sponsored Bicycling Activities (“Activity”) 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 any time I believe conditions to be unsafe, I will immediately discontinue further participation in the Activity. I further recognize that the Club requires the use of approved helmets on all rides and does not recommend any particular helmet.
  2. FULLY UNDERSTAND that: (a) BICYCLING ACTIVITIES INVOLVE RISKS AND DANGERS OF SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABLITY, 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 incur as a result of my participation in the Activity.
  3. HERBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE the Club, the LAB, their representative administrators, directors, agents, officers, 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 IN FURTHER AGREE that if, despite this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION RISK, AND INDEMNITY AGREEMENT, I or anyone on my behalf, make 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 may incur as result of such claim. I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND WITHOUT ANY INDUCEMENTS OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE COMPLETE AND CONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW, AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT.

Members Signature: (If under 18, Signature of Parent or Legal Guardian is Required)

Date
Co-Applicant Signature Date
Enclosed is my check in the amount of $ .......................................... 

Mail to: GEARS Cycling Club

P.O. Box 10244

Eugene, OR 97440

Individual Dues:….. $12.00

Household Dues:….$17.00

Contributing Member:…$45.00

Make Checks Payable to:GEARs