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I hereby acknowledge that my minor child or I have voluntarily
chosen to participate in the Manastash Metric Bike Ride
(hereinafter called “Activity”) as stated below.
I understand the risks involved with my participation in the
Activity. I recognize that the Activity involves the risk of
injury and I agree to accept any and all risks associated with
it, including but not limited to property damage or loss, minor
bodily injury, severe bodily injury, and death. Furthermore, I
recognize that participation in the Activity involves risks
incidental thereto, including but not limited to, physical
exertion for which I am not prepared, forces of nature, travel
on bicycle, terrorism, breakdown of equipment, accident or
illness without access to means of rapid evacuation or
availability of medical supplies, limited availability of
medical assistance, and the possible reckless conduct of other
participants. I am voluntarily participating in the Activity
with the knowledge of the risks involved and hereby agree to
accept any and all inherent risks of property damage, bodily
injury, and death.
I certify that my minor child or I am physically capable of
participating in the Activity and I know of no medical or health
reason which would prevent my minor child or me from
participating safely.
In consideration of my minor child’s or my participation in the
Activity and to the fullest extent permitted by law, I agree to
indemnify, defend and hold harmless Central Washington
University, its Board of Trustees, officers, directors,
employees, agents, volunteers and RSVP of Kittitas County, their
directors, volunteers, agents, owners and lessors of premises
used to conduct the Activity from and against all claims arising
out of or resulting from my minor child’s or my participation in
the Activity that may be made by me, my family, estate, heirs or
assigns. “Claim” as used in this agreement means any financial
loss, claim, suit, action, damage or expense, including but not
limited to attorney’s fees, attributable to bodily injury,
sickness, disease or death, or injury to or destruction of
tangible property including loss of use resulting there from.
I agree to assume all the foregoing risks and accept personal
responsibility for the damages following such injury, permanent
disability and death.
I give permission for University/RSVP staff to seek emergency
medical services for my minor child or myself should we become
injured or ill with the understanding that I will assume full
responsible for any and all medical expenses which may be
incurred as a result of an accident or illness.
I further understand that this assumption of risk and hold
harmless is intended to be as broad and inclusive as permitted
by the laws of the State of Washington and that if any portion
hereof is held invalid, I agree that the balance shall,
notwithstanding continue in full legal force and effect.
I have read and understand this acknowledgement of risk and hold
harmless.
Please Print
Participant’s Name:________________________
________________ _____
Last First M.I.
Participant’s Signature ________________________________
Date:_____________________________________________
Emergency Contact: __________________________________
Emergency Phone: ___________________________________
IF THE PARTICIPANT IS UNDER THE AGE OF 18, THE SIGNATURE OF A
PARENT OR GUARDIAN IS REQUIRED:
Parent Name: ____________________________________
Signature: ___________________________Date: _________
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