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Earn-A-Bike Program Enrollment
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Please Read and Agree to the following Earn-a-Bike program policies:
Program Eligibility
The Earn-a-Bike program provides access to bicycles for those who may otherwise not be able to afford a bicycle. We ask you to consider your personal circumstances and financial standing, and decide for yourself whether you are eligible for the program. If you find that you could purchase a bicycle, Key City Bike sells rideable bicycles, starting at around $50. If you feel you would be a good fit for the Earn-a-Bike program, please proceed to fill out this form. If you're not sure, please contact us at toddskitchen@keycitybike.org or stop by the shop during open hours.

Participants may receive one bike per year from Key City Bike through the Earn-A-Bike program.

Code of Conduct
All program participants are subject to Key City Bike’s Shop Rules and Policies when they are in our spaces. Anyone acting disrespectful and/or not adhering to these basic rules will be asked to leave.

Minors
Anyone age 14 and up may receive a bike from Key City Bike through our Earn-A-Bike Program. An adult must accompany minors at all times. Key City Bike may create exceptions to this policy on the basis of merit, at our discretion.

Bicycle Selection
Bicycles are chosen for participants based on the information they fill out about their height, physical restrictions, and what they plan to use the bike for. We are limited in the bicycles we have by what we receive as donations--therefore we may not be able to honor all needs and requests through the program. If at the Graduation, none of the bikes we have selected actually fits a participant, we will strive to identify a bike that would work, fix it up and have it ready for the participant as soon as possible. We will call when the bike is ready for pick-up.

The bike you are given will be in working order, however, if your new Earn-a-Bike has mechanical problems down the road, we will show you how to make repairs to your bike. Your bike is your responsibility. Please take advantage of our open shop hours to make repairs on your bike yourself, or you may pay for service at any local bike shop.

We will not install accessories on the bike. We will remove accessories that may come in on donated bikes in order to be fair to all EAB participants. If you prefer a cushier seat, a front basket, or different handlebars, that is up to you to pay for and install on your bike in your own time.

By entering your FULL NAME below, you confirm that you have read and agree to these policies:
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General Release and Liability Waiver
Please read our Release and Liability Waiver completely before checking the box below.
I hereby freely, voluntarily and without duress execute this release under the following terms which I have read and fully understand:

Release and waiver. I release and forever discharge and hold harmless Key City Bike and its successors and assigns from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from my activities or involvement with Key City Bike. I understand that this release discharges Key City Bike from any liability or claim that I may have against Key City Bike with respect to any bodily injury, personal injury, illness, death or property damage that may result from my activities or involvement with the bike depot, except where due to intentional gross negligence or willful misconduct by Key City Bike, its officers, directors, or volunteers. Key City Bike does not assume any responsibility for or obligation to provide financial assistance or other assistance, including but not limited to medical, health or disability insurance in the event of injury or illness.

Medial Treatment. I release and forever discharge Key City Bike from any claim whatsoever which arises or may hereafter arise on account of any first aid, treatment, or service rendered in connection with my activities or involvement with Key City Bike. If I should suffer injury, I hereby specifically authorize a representative or volunteer associated with Key City Bike to use their discretion to have me receive medical care including, if necessary, being transported to a medical facility and I take full legal and financial responsibility for this action and for any care or treatment I receive.

Assumption of the Risk. I understand that activities include work that may be hazardous, including, but not limited to use of power tools, other tools, construction, loading and unloading, operating a bicycle, physical presence in a bike repair facility with inherent risks and transportation to and from the facility. I hereby expressly and specifically assume the risk of injury and or harm in all activities and involvement and release Key City Bike from any and all liability for injury, illness, death, dismemberment, permanent disability and personal or property damage resulting from any activities or involvement.

Insurance. I understand that Key City Bike does not carry or maintain health, medical, disability or any other insurance coverage for any Key City Bike visitor, volunteer or participant.

Survivance. I agree that in the event that any clause or provision of this release shall be held to be invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provisions of this release, which shall continue to be enforceable.

Image and Name Usage. I hereby give full consent to Key City Bike to copyright, publish or use, for business purposes, any traditional or electronic photos, videos, likeness of me or my child, including my or my child’s name. I understand these photos may be used for publications, displays or promotional materials, with or without my name and without prior consent.

By signing this form I verify that I am eighteen (18) years of age or older and I expressly agree that this release is intended to be as broad and inclusive in protecting Key City Bike against any and all claims as permitted by the laws of the State of Minnesota.

By checking this box below, I indicate that I agree to the terms of this waiver:
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PERSONAL CONTACT INFORMATION
First Name
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Last Name
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Address
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City
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State
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Phone Number
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Parent Information
This section is required if the participant is under 18 years of age. Only adults, 18+ may complete this waiver. Minors will need their parent or guardian to complete the form for them.
Parent or Guardian FULL NAME
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Parent or Guardian PHONE
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Parent or Guardian EMAIL ADDRESS
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Relationship to Minor
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EMERGENCY CONTACT INFORMATION
In case of an emergency, who should be contacted?
Emergency Contact First Name
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Emergency Contact Last Name
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Emergency Contact Phone Number
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Emergency Contact Relationship
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Demographics
Voluntary disclosure of information, this section is optional.
How did you hear about the Key City Bike?
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Ethnicity
Age
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