"Activity Registration Form and Release Waiver for Participation in Organized Bicycle Rides" - City of Manteca, California

Activity Registration Form and Release Waiver for Participation in Organized Bicycle Rides is a legal document that was released by the Police Department - City of Manteca, California - a government authority operating within California. The form may be used strictly within City of Manteca.

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1001 W. Center Street, Manteca, California, 95337
I
www.mantecagov.com
CITY OF MANTECA
Activity Registration Form and Release Waiver
For participation in Organized Bicycle Rides
Participant’s First and Last Name
M/F
Date of Birth
Age
Household/Primary Adult Contact
First & Last Name
Relationship to Participant
Street Address
City, State, Zip
Home Phone
Work Phone
Cell Phone
E-mail Address
In consideration of the acceptance of my application for entry into the Organized Bicycle Rides hosted by the City of Manteca, I hereby
waive, release, indemnify, and hold harmless the City of Manteca, and discharge any and all claims for damages for personal injury, death,
or property damage which I may have, or which hereafter accrue to me, against the City of Manteca as a result of my participation in the
event. This release is intended to discharge the City of Manteca, its officers, officials, employees, agents and volunteers, and any other
involved municipalities or public entities from and against any and all liability arising out of or connected in any way with my participation
in the event, even though that liability may arise out of the negligence or carelessness on the part of persons or entities mentioned above,
including but not limited to myself. I further understand that accidents and injuries can arise out of the event; knowing the risks,
nevertheless, I hereby agree to assume those risks and to release and to hold harmless all of the persons or entities mentioned above to
assume those risks and to release and to hold harmless all of the persons or entities mentioned who (through negligence or carelessness)
might otherwise be liable to me (or my heirs or assigns) for damages. It is further understood and agreed that this waiver, release, and
assumption of risk is to be binding on my heirs and assigns. The City of Manteca reserves the right to photograph facilities, activities, and
program participants for potential future use. All photos shall remain the property of the City of Manteca and may be used for occasional
publicity and promotional purposes. My signature releases the City of Manteca from any and all liability and/or obligation to me and/or
my child(ren) for the use of such documentation.
By participating in this activity, I am accepting full responsibility for my own safety and well-being. I also agree to abide by all traffic and
safety laws when I participate in this activity. I understand that I am participating at my own risk and agree to stay in tune with my personal
and physical needs. I agree to immediately stop all physical activity and call for help if I experience any faintness, dizziness, shortness of
breath, pain, or any other physical fatigue and understand that the City of Manteca will not be responsible or liable for any injury or harm
I sustain as a result of participating in this event. By signing this acknowledgement, I acknowledge that I will adhere to these guidelines
and/or have instructed my child(ren) to adhere to these guidelines.
The City of Manteca recommends that you consult with your physician before beginning any physical activity or fitness program to reduce
or avoid injury. By signing below, you acknowledge that you have fully read and understand the contents of this agreement and waiver.
_______________________________________________________________
__________________________________
Participant Signature
Date
_______________________________________________________________
__________________________________
Parent/Guardian Signature (if Participant is under 18)
Date
1001 W. Center Street, Manteca, California, 95337
I
www.mantecagov.com
CITY OF MANTECA
Activity Registration Form and Release Waiver
For participation in Organized Bicycle Rides
Participant’s First and Last Name
M/F
Date of Birth
Age
Household/Primary Adult Contact
First & Last Name
Relationship to Participant
Street Address
City, State, Zip
Home Phone
Work Phone
Cell Phone
E-mail Address
In consideration of the acceptance of my application for entry into the Organized Bicycle Rides hosted by the City of Manteca, I hereby
waive, release, indemnify, and hold harmless the City of Manteca, and discharge any and all claims for damages for personal injury, death,
or property damage which I may have, or which hereafter accrue to me, against the City of Manteca as a result of my participation in the
event. This release is intended to discharge the City of Manteca, its officers, officials, employees, agents and volunteers, and any other
involved municipalities or public entities from and against any and all liability arising out of or connected in any way with my participation
in the event, even though that liability may arise out of the negligence or carelessness on the part of persons or entities mentioned above,
including but not limited to myself. I further understand that accidents and injuries can arise out of the event; knowing the risks,
nevertheless, I hereby agree to assume those risks and to release and to hold harmless all of the persons or entities mentioned above to
assume those risks and to release and to hold harmless all of the persons or entities mentioned who (through negligence or carelessness)
might otherwise be liable to me (or my heirs or assigns) for damages. It is further understood and agreed that this waiver, release, and
assumption of risk is to be binding on my heirs and assigns. The City of Manteca reserves the right to photograph facilities, activities, and
program participants for potential future use. All photos shall remain the property of the City of Manteca and may be used for occasional
publicity and promotional purposes. My signature releases the City of Manteca from any and all liability and/or obligation to me and/or
my child(ren) for the use of such documentation.
By participating in this activity, I am accepting full responsibility for my own safety and well-being. I also agree to abide by all traffic and
safety laws when I participate in this activity. I understand that I am participating at my own risk and agree to stay in tune with my personal
and physical needs. I agree to immediately stop all physical activity and call for help if I experience any faintness, dizziness, shortness of
breath, pain, or any other physical fatigue and understand that the City of Manteca will not be responsible or liable for any injury or harm
I sustain as a result of participating in this event. By signing this acknowledgement, I acknowledge that I will adhere to these guidelines
and/or have instructed my child(ren) to adhere to these guidelines.
The City of Manteca recommends that you consult with your physician before beginning any physical activity or fitness program to reduce
or avoid injury. By signing below, you acknowledge that you have fully read and understand the contents of this agreement and waiver.
_______________________________________________________________
__________________________________
Participant Signature
Date
_______________________________________________________________
__________________________________
Parent/Guardian Signature (if Participant is under 18)
Date