Seven Hills Wheelmen Membership Form

www.SevenHillsWheelmen.org

Seven Hills Wheelmen
Membership Form

Join or renew between Jan. 1 and the fall century, and your membership will expire Dec. 31 the same year.
Join at or after the fall century, and your membership is valid until Dec. 31 the next year.

First Name:

Last Name:

E-mail:

Address:

City/town:

State: ZIP code:

Telephone:

Newsletter Delivered By:

Email ($15)

We might publish a member directory that will be available only to club members. Check all that apply:

Do not publish my name or any of my contact information.
Do not publish my phone number.
Do not publish my postal address.
Do not publish my e-mail address.

Waiver and Release:

In consideration of being permitted to participate in any way in Seven Hills Wheelmen (SHW) sponsored bicycling activities, 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 to participate in such activities. I further acknowledge that the Activities will be conducted over public roads and facilities open to the public during the activities and upon which the hazards of traveling are to be expected. I further agree and warrant that if at any time I believe conditions to be unsafe, I will immediately discontinue further participation in the activity.

2. fully understand that: (a) bicycling activities involve risks and dangers of serious bodily injury, including permanent disability, paralysis and the and the risk of death; (b) these risks and dangers may be caused by my own actions or inactions, the actions or inactions of others participating in the Activities, the conditions in which the activities take place, or the negligence of the other participants designated below; (c) there may be other risks and social or economic losses either not known to me or not readily foreseeable at the 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 Activities.

3. hereby release, discharge, covenant not to sue, and agree to indemnify and save and hold harmless SHW, their representatives, administrators, directors, agents, and employees, other participants, any sponsors, advertisers, and, if applicable, owners and leasers of premises on which the Activities take 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 I further agree that if, despite this release and waiver of liability, assumption of risk, and indemnity agreement I, or anyone on my behalf, makes 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, liabiity, damage or cost which any may incur as the result of such claim.

I have read this agreement, fully understand its terms, understand that I have given up substantial rights by accepting and paying membership to Seven Hills Wheelmen it and have agreed to the waiver and release freely and without inducement or assurance of any nature and intend it to be a complete and unconditional 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.

Seven Hills WheelmenMembership Form

Seven Hills Wheelmen
Membership Form