Missed the event and still want to Pedal for Peds! You ride when and where you can - while 100% of your registration fee goes directly to support the work being done by UNC's Division of Pediatric Hematology - Oncology.
“PEDALS FOR PEDS” PARTICIPANT RELEASE FORM
I ACKNOWLEDGE THAT, BY SIGNING THIS RELEASE, I AM RELEASING THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL, THE UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM, THE UNIVERSITY OF NORTH CAROLINA HOSPITALS AT CHAPEL HILL, THE UNC LINEBERGERR COMPREHENSIVE CANCER CARE CENTER, AND THEIR REPRESENTATIVES, AGENTS, EMPLOYEES, VOLUNTEERS, MEMBERS, SPONSORS, PROMOTERS, AND AFFILIATES (COLLECTIVELY “RELEASEES”) FROM LIABILITY, AND THAT I AM GIVING UP SUBSTANTIAL LEGAL RIGHTS. THIS ENTRY FORM AND RELEASE IS A CONTRACT WITH LEGAL AND BINDING CONSEQUENCES AND IT APPLIES TO ALL ACTIVITIES ENTERED AT THE “PEDALS FOR PEDS” EVENT (THE “EVENT”), REGARDLESS OF WHETHER SUCH ACTIVITY IS SPECIFICALLY IDENTIFIED HEREIN. I HAVE READ THIS RELEASE CAREFULLY BEFORE SIGNING. I UNDERSTAND WHAT THIS RELEASE MEANS AND WHAT I AM AGREEING TO BY SIGNING.
In consideration of the acceptance of my application for entry in the Event, I hereby freely agree to and make the following contractual representations and agreements:
I acknowledge that biking (including road, trail, and stationary biking) and other exercise activities are inherently dangerous activities and FULLY ASSUME THE RISKS ASSOCIATED WITH PARTICIPATING IN THE EVENT, INCLUDING, for example (but not limited to): the dangers of collision with vehicles, other racers, and other fixed and moving objects or people; the dangers arising from surface hazards (including pot holes), THE RELEASEES’ OWN NEGLIGENCE, the negligence of others, and weather conditions; strenuous exertions of various muscles placing stress on the muscles, bones, and joints; sustained physical activity placing stress on the heart, arteries, and blood pressure; minor injuries such as soreness, sprains, strains, and bruises, and the possibility of serious physical and/or mental trauma, injury, or death associated with the Event.
For myself, my heirs, executors, administrators, legal representatives, assignees, and successors in interest (collectively, “Successors”), I HEREBY WAIVE, RELEASE, DISCHARGE, HOLD HARMLESS, AND PROMISE TO INDEMNIFY AND NOT SUE the Releasees and the organizer of the Event and any property owners, law enforcement agencies, public entities, special districts and properties that are in any manner connected with the Event, and their respective agents, officials, and employees, (the foregoing are also collectively deemed to be Releasees) FROM ANY AND ALL RIGHTS AND CLAIMS, INCLUDING CLAIMS ARISING FROM THE RELEASEES’ OWN NEGLIGENCE TO THE MAXIMUM EXTENT PERMITTED BY LAW, which I have or which may hereafter accrue to me or my Successors, and from any and all damages that may be sustained by me directly or indirectly in connection with, or arising out of, my participation in or association with the Event, or travel to or return from the Event.
I understand that I am responsible for my own conduct and decisions while participating in the Event and agree that this Release shall apply to any claim arising out of my participation in all activities in the Event. I agree it is my sole responsibility to be familiar with the Event course and agenda, the Releasees’ rules, and any special regulations for the Event, and I agree to comply with all such rules and regulations. I understand and agree that situations may arise during the Event that may be beyond the control of the Releasees, and that I must continually participate so as not to endanger myself or others. I have no medical or physical condition that, to my knowledge, could endanger myself or others if I participate in the Event, or could interfere with my ability to safely participate in the Event. To the extent I am using my own equipment while participating in the Event, such equipment will be in proper working equipment.
I agree, for myself and my Successors, that the above representations are contractually binding, and are not mere recitals, and that should I or my Successors assert any claim contrary to what I have agreed to in this Release, the claiming party shall be liable for the expenses (including legal costs and attorneys’ fees) incurred by the Releasees in defending such claim. This Release may not be modified orally or otherwise, and a waiver or modification of any provision shall not be construed as a waiver or modification of any other provision herein, or as a consent to any subsequent waiver or modification.
I consent to the release by any third party to Releasees and their insurance carriers of my name and medical information that may relate solely to any injury or death I may suffer arising from the Event.
I further agree to allow Releasees to use any photographs, videos or images of me without payment for Releasees’ marketing or public relations purposes.
Every term and provision of this Release is intended to be severable. If any one or more of them is found to be unenforceable or invalid, that shall not affect the other terms and provisions, which shall remain binding and enforceable.
SIGNATURE OF PARTICIPANT DATE
NAME OF PARTICIPANT (print)______________________________
AGE ON DAY OF EVENT___________
EMERGENCY CONTACT PHONE______________________________
CONSENT AND RELEASE OF PARENT OR GUARDIAN
I am the parent or guardian of ______________________ (“Child”). My Child is fit for the Event, and I consent to my Child’s participation. I HAVE READ AND I UNDERSTAND THE ABOVE RELEASE. In consideration of allowing my Child to participate, I consent to the Release and agree that ITS TERMS SHALL LIKEWISE BIND ME, MY CHILD, and our Successors. For myself, my Child, and our Successors, I HEREBY RELEASE AND SHALL DEFEND, INDEMNIFY, AND HOLD HARMLESS THE RELEASEES FROM EVERY CLAIM AND ANY LIABILITY that I, my Child or our Successors may allege against the Releasees (including reasonable legal costs and attorneys’ fees) as a direct or indirect result of injury or death to me, my Child or our Successors because of my Child’s participation in the Event, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERS TO THE MAXIMUM EXTENT PERMITTED BY LAW. I, MY CHILD AND OUR SUCCESSORS PROMISE NOT TO SUE RELEASEES regarding any claim arising from or related to my Child’s participation in the event.
SIGNATURE OF PARENT OR GUARDIAN DATE
WAIVER: I, the undersigned participant (and my parent or guardian if I am younger than 18 years of age), intending to be legally bound, do hereby forever release and waive any and all rights, claims, and actions for damages that we, our heirs, executors, administrators, and assigns may have, or that may hereafter accrue against any and all persons, organizations, and other entities associated with the event, including, but not limited to Race Entry LLC, USA Track and Field, sponsors, affiliates, volunteers, and individual race organizers, arising out of or in connection with my involvement before, during, or after the event.
I verify that I am physically fit and sufficiently trained to participate in this event and I assume the risks involved in this activity. I further attest that I will be mindful of traffic along the race course, and hold said sponsors and organizers blameless in any harm that may happen.
I also acknowledge understanding that the charge to my card will show up as Race Entry LLC. I acknowledge that the online processing fees and charitable donations are non-refundable. I also acknowledge that any charitable donations will have 4.97% withheld from the donation to pay credit card and administrative costs.
Race Entry LLC shall not be liable to you for any direct, indirect, special, incidental, consequential or exemplary damages including, but not limited to, loss of profits, goodwill, use, data or other intangible loses. Race Entry LLC does not guarantee the completeness or accuracy of any information contained in, or provided in conjunction with the http://www.raceentry.com website. Race Entry LLC is not responsible for any omissions or inaccuracies, or for the results obtained from this information.
Race Entry LLC facilitates registration for various events, some of which allow participants under the age of thirteen (13). We require a submission of birth date for all registration entries. For children under the age of thirteen (13), parental or guardian consent is required.
You agree that the statutes and laws of the State of Utah, USA, will apply to all matters relating to this Agreement and Waiver. You irrevocably consent that exclusive jurisdiction for any dispute with Race Entry LLC relating to this Agreement and Waiver resides in the courts of Utah, and you further agree and expressly consent to the exercise of personal jurisdiction in the courts of Utah in conjunction with any such dispute including any claim involving Race Entry LLC .