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Bring Your Own Big Wheel

Event Waiver & Release

TO BE COMPLETED BY ALL RIDERS (If under 18, guardian signature needed)

In signing this registration form or submitting it electronically I acknowledge that it is a waiver and release for my participation in the Bring Your Own Big Wheel event. I understand the intent thereof, and I hereby agree to release from responsibility and waive all claims against any other parties connected with the Bring Your Own Big Wheel in any way, or person, singly or collectively, for any blame or liability, demand, injury, harm, loss of property, or damage I might sustain as a result of participation in the Bring Your Own Big Wheel event and activities associated therewith. I understand that this event is outdoors in any weather, I may trip or fall or collide with another person or various objects and I fully accept and assume all risks and all responsibility for losses, costs and damages for my person or property I incur as a result of my participation in the Bring Your Own Big Wheel event.

I certify that I have read this waiver, fully understand that I have given up substantial rights by signing this waiver and have signed this waiver freely of my own will and accord. I confirm that the contact information I have provided is correct. I also agree to adhere to the Code of Conduct listed on www.BringYourOwnBigWheel.com.

I give full permission for the use of my name and photographs or video of me in connection with Bring Your Own Big Wheel.

Participant Name: _________________________________________________

Participant Signature:_______________________________________________

DATE SIGNED:______________________

Parent/Guardian Name:__________________________________________________

Parent/Guardian Signature________________________________________________

DATE SIGNED:_____________________

Emergency Phone Number: (_____)_________________