Confidence Building Skills Clinic
Saturday May 22, 2021
Participant Contact Information
Emergency Contact Name
Emergency Contact Phone Number
How did you hear about us?
Local Bike Shop
Individual Registration ($80.00) [5 remaining]
Date of Birth
Terms & Agreements
WAIVER/RELEASE FOR COMMUNICABLE DISEASES INCLUDING COVID-19
ASSUMPTION OF RISK / WAIVER OF LIABILITY / INDEMNIFICATION AGREEMENT
In consideration of being allowed to participate on behalf of Non Dot Adventures small group clinic the undersigned acknowledges, appreciates, and agrees that:
1. Participation includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; and,
2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,
3. I willingly agree to comply with the stated and customary terms and conditions for participation as regards protection against infectious diseases. If, however, I observe and any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and,
4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Non Dot Adventures their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IF FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
I have read and agree to the terms above.
Terms & Agreements
I understand that Mountain Biking is an inherently dangerous sport.
I Indemnify and Hold Harmless Non Dot Adventures, OC Parks, their employees, volunteers, and sponsors for any injuries or property damage I may incur.
I acknowledge that this athletic event limits and carries with it the potential for death, serious injury and property loss. The risks include, but are not limited to, those caused by terrain, darkness, facilities, altitude, temperature, weather, condition of athletes, equipment, vehicular traffic, actions of other people including but not limited to, participants, volunteers, coaches, and/or producers of the event, and lack of hydration. These risks are not only inherent to athletes, but are also present for volunteers. I hereby agree to assume all of the risks of participating and/or volunteering in the Non Dot Adventures skills clinic. I realize that liability may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective property owned, maintained, or controlled by them or because of their liability without fault.
Non Dot Adventures has put in place preventative measures to reduce the spread of COVID-19; however, the Club cannot guarantee that you will not become infected with COVID-19. Further, attending this clinic could increase your risk of contracting COVID-19.
By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk I may be exposed to or infected by COVID-19 by attending the clinic and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at the clinic may result from the actions, omissions, or negligence of myself and others, including, but not limited to, employees, volunteers, and clinic participants. By showing up to the clinic, I declare that I have no symptoms of COVID-19 and am otherwise in good health.
I certify that I am physically fit, have trained sufficiently for participating in this event and have not been advised otherwise by a qualified medical person.
I acknowledge that this Accident Waiver and Release of Liability form will be used by the event holders, sponsors and organizers of the event in which I may participate and that it will govern my actions and responsibilities at said event.
In consideration of my application and permitting me to participate in The Non Dot Adventures skills clinic I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) Waive, Release and Discharge from any and all liability for my death, disability, personal injury, property damage, property theft or actions of any kind which may hereafter accrue to me including attorney's fees, litigation costs and my traveling to and from The Non Dot Adventures skills clinic.
THE FOLLOWING ENTITIES OR PERSONS: Non Dot Adventures, Orange County Parks & the State of California, their directors, managers, officers, employees, volunteers, representatives and agents, the event holders, event directors, event sponsors, event staff, vendors, event volunteers, representatives and agents, the event holders, event directors, event sponsors, event staff, vendors, event volunteers, property owners, (B) Indemnity and Hold Harmless the entities or persons mentioned in this paragraph from any and all liabilities of claims made as a result of participation in the Non Dot skills clinic, whether caused by the negligence of releases or otherwise.
I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident and/or illness during this event.
I understand that at this event or related activities, I may be photographed I agree to allow my photo, video or film likeness to be used for any legitimate purpose by the event holders, producers, organizers and/or assigns.
This Accident Waiver and Release of Liability shall be constructed broadly to provide a release and waiver to the maximum permissible under application law.
I, the undersigned, agree to the terms above.
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