Print, sign and mail the below ADULT waiver/release form (required for each ADULT ride participant).
Brianna Catherine Rahilly's Ride Release Form
(For Adults)
Event: Brianna Catherine Rahilly's Memorial Ride for The SIDS Center of New Jersey.
Date: September, 27th 2009
Location: Mills H-D (Burlington, NJ) -to- Pic-a-lilly Resturant (Shamong, NJ)
The undersigned (on my own behalf and on behalf of my heirs, personal representatives, successors and assigns), for and in consideration of the opportunity to participate in a "Ride,"(hereinafter, EVENT(S) sponsored and/or conducted by The SIDS Center of New Jersey , and their respective officers, directors, employees and agents (hereinafter, the "RELEASED PARTIES") releases and holds harmless the "RELEASED PARITES" from any and all claims and demands, rights and causes of action of any kind whatsoever which I now have or later may have against the "RELEASED PARTIES" in any way resulting from, arising out of, or in connection with the performance of their chapter duties and my participation in any said EVENT(S).
This Release extends to any and all claims I have or later may have against the "RELEASED PARTIES" resulting from or arising out of their performance of there chapter duties whether or not such claims result from regligence (except willful neglect) on the part of any or all the "RELEASED PARTIES" with respect to the EVENT(S) of with respect to the conditions, qualification, instructions, rules or procedures under which the EVENT(S) are conducted of from any other cause. I UNDERSTAND THAT THIS MEANS THAT I AGREE NOT TO SUE ANY OR ALL OF THE "RELEASED PARTIES" FROM ANY INJURY RESULTING TO MYSELF OR MY PROPERTY ARISING FROM, OR IN CONNECTION WITH THE PERFORMANCE OF THEIR CHAPTER DUTIES INSPONSORING, PLANNING, OR CONDUCTION THE EVENTS.
I am experienced in and familiar with the operation of motorcycles and fully understand the risks and dangers inherent in motorcycling, I am voluntarily participating in the EVENT(S) and I expressly agree to assume the entire risk of any accidents or personal injury, including death, which I might sustain to my person and property as a result of my participation in the events, and any negligence (except willful neglect) on the part of any of all of the "RELEASED PARTIES" in performing their chapter duties.
WAIVER OF RIGHTS UNDER STATE STATUTES
I fully agree to waive all benefits flowing from any state statue which would negate or limit the scope of this release and Indemnification Agreement, including but not limited to Section 1542 of the California Civil Code which provides:
" A general release does not extend to the claims which the creditor does not know or suspect to exist in hi favor at the time of executing this release, which if known to him must have materially affected his settlement with the debtor. "
By signing this Release, I certify that I have read this Release and fully understand it and that I am not relying on nay statements or representatives made by the "RELEASED PARTIES"
THIS IS A RELEASE - READ BEFORE SIGNING
RIDER PASSENGER
Signature ______________________________ Signature ______________________________
Print Name ______________________________ Print Name ______________________________
Address ______________________________ Address ______________________________
City/State/Zip ______________________________ City/State/Zip ______________________________
Date ______________________________ Date ______________________________
Print, sign and mail the below CHILD/MINOR waiver/release form (required for each CHILD/MINOR ride participant).
Brianna Catherine Rahilly's Ride Release Form
(For Child/Minor)
Event: Brianna Catherine Rahilly's Memorial Ride for The SIDS Center of New Jersey.
Date: September, 27th 2009
Location: Mills H-D (Burlington, NJ) -to- Pic-a-lilly Resturant (Shamong, NJ)
In consideration of my minor child ("the MINOR") being permitted to particpate in a "RIDE", (herein after, EVENT(S) sponsored and/or conducted by The SIDS Center of New Jersey and their representive officers, directors, employees, and agents (hereinafter, the "RELEASED PARTIES") I agree as follows:
1. I know the nature of the EVENT(S) and the Minor's experience and capabilities, and believe the Minor to be qualified to participate, in the EVENT(S) or enter into restricted areas where the EVENT(S) are conducted. IF I OR THE MINOR BELIEVE ANYTHING IS UNSAFE, I WILL INSTRUCT THE MINOR TO IMMEDIATELY CEASE AND REFUSE TO PARTICIPATE FURTHER IN THE EVENT(S) AND/OR LEAVE THE RESTRICTED AREA.
2. I FULLY UNDERSTAND and will instruct the MINOR that (a) THE ACTIVITIES OF THE EVENT(S) MAY BE DANGEROUS and participation in the EVENT(S) and/or enter into Restricted Areas my involve RISKS AND DANGERS OF SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS AND DEATH ("RISKS"); (b) these Risks and dangers may be caused by the Minor's own actions or inactions, the actions or inactions of others participating in the EVENTS(S), the rules of the EVENT(S), the condition and layout of the premises and equipment, or THE NEGLIGENCE OF THE "RELEASED PARTIES" in performing their chapter duties; (c) there may be OTHER RISKS NOT KNOWN TO ME or that are not readily foreseeable at this time; (d) THE SOCIAL AND ECONOMIC LOSSES and/or damages that could result from those Risks COULD BE SEVERE AND COULD PERMANENTLY CHANGE THE MINOR'S FUTURE.
3. I consent to the Minor's participation in the EVENT(S) and/or entry into resticted areas and HEREBY ACCEPT AND ASSUM ALL SUCH RISKS KNOW AND UNKNOWN, AND ASSUME ALL RESPONSIBILITY FOR THE LOSSES, COSTS AND/OR DAMAGES FOLLOWING SUCH INJURY, DISABILITLY, PARALYSIS OR DEATH, EVEN IF CAUSED, IN WHOLE OR IN PART, BY THE NAGLIGENCE OF THE "RELEASED PARTIES' IN PERFORMING THEIR CHAPTER DUTIES.
4. I HEREBY RELEASE, DISCHARGE AND CONVENANT NOT TO SUE THE "RELEASED PARTIES" sponsors, advertisers, owners and lessors of the premises used to conduct the EVENT(S), FROM ALL LIABILITY TO ME, THE MINOR, my and the minor's personal representatives, assigns, heirs, and next of kin FOR ANY AND ALL CLAIMS, DEMANDS, LOSSES OR DAMAGES ON ACCOUNT OF ANY INJURY, including, but not limited to, death or damage to property, CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE "RELEASED PARTIES" in performing their chapter duties.
5. If desite, this release, I, the Minor of anyone on the Minor's behalf makes a claim against any of the "RELEASED PARTIES" named above, I AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS THE "RELEASED PARTIES" AND EACH OF THEM FROM ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS, LIABILITY, DAMAGE, OR COST THEY MAY INCUR DUE TO THE CLAIM MADE AGAINST ANY OF THE "RELEASED PARTIES" NAMED ABOVE, ASSERTING NEGLIGENCE ON THE PART OF THE "RELEASED PARTIES" IN PERFORMING THEIR CHAPTER DUTIES.
6. I sign this agreement on my own behalf and on behalf of the Minor.
I HAVE READ THIS PARENTAL CONSENT, RELEASE AND WAIVER OF LIABILITY, ASSUMPTON OF RISK, AND INDEMNITY AGREEMENT, UNDERSTAND THAT MY SIGNING IT I GIVE UP SUSTANTIAL RIGHTS I AND/OR THE MINOR WOULD OTHERWISE HAVE TO RECOVER DAMAGES FOR LOSSES OCCASIONED BY THE "RELEASED PARTIES" FAULT, AND SIGN IT VOLUNTARILY AND WITHOUT INDUCEMENT.
CHILD'S NAME (PRINTED) _______________________________
_______________________________ _______________________________
SIGNATURE OF PARENT OR GUARDIAN PRINTED NAME OF PARENT OR GUARDIAN