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Motherland Cycling Club - Saturday Ride
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Name and Address
First Name *
Last Name *
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Emergency Contact - Full Name *
Emergency Contact Phone # *
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Release and Waiver
In consideration of being accepted to participate in club rides and/or events, including transportation to and from same, I do hereby for myself, my heirs, executors and administrators, release and forever discharge Motherland Cycling Club, its officers and members from any and all claims, demands, actions and/or liabilities on account of any injury to me which may occur from any cause whatsoever, including negligence or other fault on the part of anyone released hereunder, during my participation in or transportation to or from said club rides and/or events. I acknowledge I am aware of the risks and hazards inherent upon engaging in said club activities, and I do so entirely upon my own initiative, risk and responsibility. I further understand the club depends upon its members to provide and lead club activities and that those members rely on the protection afforded hereunder. I hereby further agree to operate my bicycle in a manner that is safe to me and those around me, to observe all applicable safety regulations and to conduct myself in a manner that will be complimentary to the sport of bicycling. It is my intent this release and waiver apply at all times, notwithstanding my membership in Motherland Cycling Club may have expired, relapsed, been renewed or reinstated after a period of non-membership.
I further acknowledge I have read the forgoing release and waiver and understand it, including it is intended to cover occurrences which may not yet have occurred and which are unknown to me, and notwithstanding the foregoing, I agree to be bound by it  voluntarily and with full intent it is forever enforceable. I understand, and agree that all children under legal age MUST be accompanied by a parent at ALL club functions. *
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