In consideration of the acceptance of my application, I, for myself, my heirs, executors, administrators, successors and assigns, waive, release and discharge all claims for damages resulting from death, personal injury or property damage which I may have, or which may hereafter accrue to me as a result of my participation with this organization. I understand this release is intended to discharge and release, in advance, the Oakland Yellow Jackets Bicycle Club, its members and their respective agents, officers, officials, servants and representatives, and any involved municipalities and their respective agents and employees from and against any and all liability arising out of or connected in any way with my participation with this organization even though that liability may arise out of negligence or carelessness on the part of the person or entities mentioned above. I further understand that serious accidents occasionally occur during bicycle rides and that participants in such events occasionally sustain serious personal injury, death and/or property damage as a consequence of that participation. Nevertheless, knowing the risks of bicycling, I, for myself, my heirs, executors, administrators, successors and assigns hereby agree to assume those risks and to release and hold harmless all of the persons or entities mentioned above, who, through their negligence or carelessness, might otherwise be liable to me for damages.
I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability and a contract between myself and the Oakland Yellow Jackets Bicycle Club and agree on my own free will.
SIGNED ______________________________________________ DATE _________________________
PRINTED NAME _____________________________________ CELL NO. _________________________
EMERGENCY CONTACT _______________________________ PHONE NO. ___________________