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SPECIAL EVENT & LIABILITY RELEASE AGREEMENT
(PLEASE READ CAREFULLY BEFORE SIGNING)
The 4th Annual Katelynn Stinnett National Memorial Ride for Child Abuse Prevention & Awareness of Southern California
June 16, 2012
I consent to participate in this event:
"THE 4th ANNUAL KATELYNN STINNETT NATIONAL MEMORIAL RIDE FOR CHILD ABUSE PREVENTION AND AWARENESS" Motorcycle Run.
I understand that any and all recreational activities involve inherent risks of injury & death; and in consideration for being permitted to participate in this event, I voluntarily agree to expressly assume all risks of injury and/or death that may result from my participation.
I, the undersigned agree to indemnify and hold harmless the
Co-Founder/Coordinator, Beth Reinstein ("The Peanut"), Glendale Harley-Davidson, Cook's Corner, Event Sponsors & their employees, Successors-in-Interest, and Assigns (collectively called "Providers") or Agents against all liability of loss or damage that the participant )and/or family, relatives or participant's guests may sustain or incur as a result of claims, demands or cost of judgements arising from participant's involvement in
"The 4th Annual Katelynn Stinnett National Memorial Ride for Child Abuse Prevention & Awareness" Motorcycle Run.
Participant(s) acknowledged he/she/they have liability insurance as required by the State of California Dept of Motor Vehicles CVC 16200 Section (a-d). Participant(s) agree to drive safely at all times, to conduct themselves in a responsible manner, to comply with all applicable safety and DOT laws as well as the rules and policies of the event and any participating facilities.
I authorize any person connected with the providers or the event to administer first aid to me, as they deem necessary. I authorize medical and surgical care and transportation to a medical facility or hospital for treatment necessary for my well-being, at my expense.
I agree that any and all photographs, video, motion picture and media coverage during this event are the property of their respective owners.
All images of me, including reproductions, likeness' or resemblance
of the same in any form; as well as my name may in any manner be used, published, displayed, dealt in and copyrighted (by providers, their successors and assigns; or by any other person or business entity authorized by providers) without any restriction or limitation whatsoever, for the marketing and promotion of future events.
This agreement is binding upon my heirs, executors, administrators and assigns.
I acknowledge that this agreement is governed by applicable laws of the State of California.
If any provision of this agreement is held in whole or in part to be unenforceable for any reason, the remainder of that provision and of the entire agreement will be severable and remain in effect.
I HAVE READ, UNDERSTAND AND VOLUNTARILY AGREE TO THIS AGREEMENT AND RELEASE OF LIABILITY.
Rider's Release Signature:________________________________________Date:__________
Address/City
State/Zip___________________________________________________
Email/Phone____________________________/____________________
Passenger's Release Signature:_____________________________________Date:__________
Address/City
State/Zip____________________________________________________
Email/Phone____________________________/____________________
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Ride Waiver
