EBC Club Ride Miles
Enter email address for conformation email
Sign in to Google to save your progress. Learn more
Email *
What is your First and Last name? *
What is the date of the ride you are doing? *
MM
/
DD
/
YYYY
What route are you doing? *
If you are doing a special event or hosted ride, select “Special event/hosted ride” and include the name of the ride in the “Additional information or comments” below
What was the posted start time of the ride? *
Time
:
How many miles on the above route did you complete? *
Additional Information or comments-
Liability Release - Selecting "Submit" constitutes acceptance of this liability release
This is a legally binding agreement.  By signing this agreement, you give up your right to bring a court action to recover compensation for any injury to yourself, your child or your property resulting from your or your child’s participation in this ride regardless of the cause of your or your child’s injury including the negligence of the Evansville Bicycle Club (EBC Inc.), its officers, directors, volunteers, agents and sponsors.

Riding a bicycle on public roads with other traffic is an inherently dangerous activity, which could result in property damage, serious injury, permanent disability or death.  The risks associated with cycling include, but are not limited to: dangerous roadways, intersections and traffic; collisions with motor vehicles, animals, other riders or stationary objects; falls due to poor road conditions, mechanical problems or rider error; exhaustion; and dangerous weather conditions.  I acknowledge and agree that this list does not state all possible risks associated with cycling and that the list in no way limits this release and indemnification agreement.

I hereby acknowledge the risk inherent in cycling and acknowledge that I am solely responsible for myself and my child while participating in this ride.  I acknowledge that the EBC Inc. is not responsible for unaccompanied minors.  In consideration of my or my child’s participation in this event, I/We the undersigned on behalf of myself, my child, my/my child’s heirs, representatives, executors and assigns Do Hereby Release the EBC Inc., its officers, directors, volunteers, agents and sponsors from any cause of action, claim or demands of any nature whatsoever, including a claim of negligence by the EBC Inc., its officers, directors, employees, volunteers, agents and sponsors arising from or related to my/my child’s participation this ride. I/We further agree to indemnify, defend and hold harmless the EBC Inc., its officers, directors, volunteers, agents and sponsors from all causes of action, claims or demands of any nature whatsoever arising from, or related to my/my child’s participation in this ride including but not limited to EBC Inc.’s reasonable attorneys fees and costs, compensatory and/or punitive damages.

I/We hereby certify that we have read and understood the foregoing release and that I/We have signed it as our voluntary act with the aim of releasing the EBC Inc., its officers, directors, volunteers agents and sponsors from all liability of any kind, including their own negligence.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report