2012 USA Cycling National Championships- Augusta, GA VOLUNTEER FORM

The 2012 USA Cycling National Championships is back in Augusta, GA June 20-24 and you can be a part of all the action! Volunteer opportunities to help will begin mid-week prior to the three race venues at Fort Gordon, J. Strom Thurmond Dam, and downtown Augusta. This is the second year that Augusta will host one of USA Cycling’s most popular and competitive events, the Juniors, U23, Elite & Paralympic Road National Championships. Over 1000 athletes are expected to compete for national championships in road, individual time trial and criterium disciplines. This event will also be announcing the team of this summer's 2012 London Paralympic team!!! Thank you for being a part of making this event a success! Please indicate the dates and times you are available to volunteer, and select your preferred volunteer opportunity. Click on the link to view the list of available volunteer jobs and its description- http://augustasportscouncil.org/whatsnew/Blog/post/Volunteers-Needed-for-USA-Cycling-National-Championships.aspx. We will do our best to place you at your preferred site. If you have any questions please feel free to contact Michelle Naval at michelle@augustasportscouncil.org or 706.722.8326x231. *VOLUNTEER ORIENTATION Thursday June 14, 2012 5:30PM at the Hilton Garden Inn in the Willow Room C (1065 Stevens Creek Road Augusta , GA 30907, Last room on the left)*
* Required

USA Cycling, Inc. Volunteer Waiver

In consideration of the event or program organizer allowing me the opportunity to participate in the above named program or event: I ACKNOWLEDGE THAT BY SIGNING THIS DOCUMENT, I AM SOLELY RESPONSIBLE FOR ALL INJURIES, LOSSES, OR DAMAGES THAT I MAY SUFFER OR INCUR IN CONNECTION WITH THE PROGRAM OR EVENT IDENTIFIED ABOVE OR ANY FUTURE PROGRAM OR EVENT ASSOCIATED WITH USA CYCLING. I FURTHER AGREE TO INDEMNIFY, TO HOLD HARMLESS, AND NOT TO SUE USA CYCLING, INC. (USAC), USA CYCLING DEVELOPMENT FOUNDATION (USACDF), OR THEIR RESPECTIVE AGENTS, INSURERS, EMPLOYEES, VOLUNTEERS, MEMBERS, CLUBS, OFFICIALS, SPONSORS, EVENT DIRECTORS, LOCAL ASSOCIATIONS, AND AFFILIATES (COLLECTIVELY "RELEASEES") FOR ANY INJURIES, LOSSES, OR DAMAGES THAT I MAY SUFFER OR INCUR. I UNDERSTAND THAT I AM GIVING UP SUBSTANTIAL LEGAL RIGHTS. THIS DOCUMENT IS A CONTRACT WITH LEGAL AND BINDING CONSEQUENCES AND IT APPLIES TO ALL ACTIVITIES AT THE EVENT, REGARDLESS WHETHER LISTED OR NOT ABOVE. I HAVE READ IT CAREFULLY BEFORE SIGNING, AND I UNDERSTAND WHAT IT MEANS AND WHAT I AM AGREEING TO BY SIGNING. I ACKNOWLEDGE THAT CYCLING IS AN INHERENTLY DANGEROUS SPORT AND FULLY REALIZE THE DANGERS OF PARTICIPATING IN THE BICYCLE PROGRAM OR EVENTS, AND FULLY ASSUME THE RISKS ASSOCIATED WITH SUCH PARTICIPATION INCLUDING, by way of example, and not limitation: the dangers associated with man made and natural jumps; the dangers of collision with pedestrians, vehicles, riders, and fixed or moving objects; the dangers arising from surface hazards, including pot holes, equipment failure, inadequate safety equipment, use of equipment provided by the event or program organizer and others, THE RELEASEES' OWN NEGLIGENCE, the negligence of others and weather conditions; and the possibility of serious physical and/or mental trauma or injury, or death associated with a cycling event or program. For myself, my heirs, executors, administrators, legal representatives, assignees, and successors in interest (collectively "Successors") I HEREBY WAIVE, RELEASE, DISCHARGE, HOLD HARMLESS, AND PROMISE TO INDEMNIFY AND NOT TO SUE the Releasees and all sponsors , organizers, promoting organizations, property owners, law enforcement agencies, public entities, special districts and properties that are in any manner connected with the USA Cycling program or event, and their respective agents, officials, and employees through or by which the event or program will be held, (the foregoing are also collectively deemed to be Releasees), FROM ANY AND ALL RIGHTS AND CLAIMS INCLUDING CLAIMS ARISING FROM THE RELEASEES' OWN NEGLIGENCE TO THE MAXIMUM EXTENT PERMITTED BY LAW, which I have or which may hereafter accrue to me, and from any and all damages which may be sustained by me directly or indirectly in connection with, or arising out of, my participation in or association with the program or events, or travel to or return from the program or events. I agree it is my sole responsibility to be familiar with the course of the program or events, the Releasees’ rules, and any special regulations for the program or events and agree to comply with all such rules and regulations. I understand and agree that situations may arise during the program or events which may be beyond the control of Releasees, and I must participate so as to neither endanger myself nor others. I accept responsibility for the condition and adequacy of my equipment, any equipment provided for my use, and my conduct in connection with the program or events. I have no physical or medical condition which would endanger myself or others if I participate in the program or events, or would interfere with my ability to safely participate in the program or events. I agree, for myself and my Successors, that the above representations are contractually binding, and are not mere recitals, and that should I or my Successors assert a claim contrary to what I have agreed to in this contract, the claiming party shall be liable for all expenses (including legal fees) incurred by Releasees in defending the claims. This contract may not be modified orally, and a waiver or modification of any provision shall not be construed as a waiver or modification of any other provision herein or as consent to any other waiver or modification. I acknowledge and participate in the program or events subject to the limitations and conditions of insurance coverage stated in the beginning of this contract. I consent to the release by any third party to Releasees and their insurance carriers of my name and medical information that may relate solely to any injury or death I may suffer arising from the program or events. Every term and provision of this contract is intended to be severable. If any one or more of them is found to be unenforceable or invalid, that shall not affect the other terms and provisions, which shall remain binding and enforceable. In the event that I am unable to do so on my own because of an injury, I consent to administration of first aid and other medical treatment in the event of injury and agree to pay the costs of any such treatment.


I am the parent or guardian of ___________________(Child). My Child is fit and capable to participate in the above program or event, and I consent to my Child's participation. I HAVE READ AND I UNDERSTAND THE ABOVE CONTRACT. In consideration of allowing my Child to participate, I consent to the contract and agree that ITS TERMS SHALL LIKEWISE BIND ME, MY CHILD, and our heirs, legal representatives, and assignees. I HEREBY RELEASE AND SHALL DEFEND, INDEMNIFY AND HOLD HARMLESS THE RELEASEES FROM EVERY CLAIM AND ANY LIABILITY that I or my Child may allege against the Releasees (including reasonable legal fees and costs) as a direct or indirect result of injury or death to me or my Child because of my Child's participation in the program or events, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERS TO THE MAXIMUM EXTENT PERMITTED BY LAW. I PROMISE NOT TO SUE RELEASEES on my behalf or on behalf of my Child regarding any claim arising from my Child's participation in the program or events.

USA Cycling, Inc.


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