Waiver & Release of Liability Form

In recognition of the inherent risks of the activity in which I will engage, I confirm that I am physically and mentally capable of participating in the activity and using the equipment. I further acknowledge that I am participating willingly and voluntarily. I knowingly and freely assume all such risks, both known and unknown, including, but not limited to personal bodily, or mental injury, accidents, illnesses, and death, even if arising from the negligence of those persons released from liability herein and assume full responsibility for my participation. I also assume all responsibility for damage to or loss of personal property (my own or damage to others caused by my negligence) as the result of any accident that may occur. I hereby authorize any medical treatment deemed necessary in the event of any injury while participating in the activity. I either have appropriate insurance or in its absence, agree to pay all costs of rescue and/or medical services as may be incurred on my/our behalf. In consideration of services or property provided, I, on behalf of my heirs, successors, assigns, next of kin, and personal representatives, do hereby release Joseph Fick and EbikeTestRides.com, its principals, directors, trustees, officers, agents, employees, and volunteers from all liability arising out of the activity and waive any claim for damage arising from any cause whatsoever, including but not limited to all personal, bodily or mental injury, disability, death, and loss or damage to person or property, whether caused by the negligence of the those persons released or otherwise. I also agree to indemnify and hold harmless Joseph Fick and EbikeTestRides.com, its principals, directors, trustees, officers, agents, employees and volunteers from all claims, judgments, and costs, including attorney’s fees, incurred in connection with any action brought as a result of my participation in or observation of the activities. I HAVE READ THE FOREGOING RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, AND I UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

I Agree

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If Participant is Under 18

If participant is under 18, the Parent or Legal Guardian must read this form and sign below: This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree not only to his/her release of NORTHTOWNE LTD its principals, directors, trustees, officers, agents, employees and volunteers, but I also agree to release, indemnify and hold harmless NORTHTOWNE LTD its principals, directors, trustees, officers, agents, employees and volunteers from any and all liabilities incident to said participant’s involvement in these programs on behalf of myself, my heirs, successors, assigns next of kin, and personal representatives.

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