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2011 Membership Form

NOTICE: the membership and release form is a contract with legal consequences.
Read it carefully before signing.

In consideration of the acceptance of my membership, I hereby freely agree to and make the following contractual representations and agreements.

I fully understand the dangers of participating in bicycle riding and training and fully assume the risks associated with such participation including, by way of example, and not limitation, the following: The dangers of collision with pedestrians, vehicles, and other riders, and fixed or moving objects; the dangers arising from the surface hazards, equipment failure, inadequate safety equipments, and weather conditions; and the possibility of serious and/or mental trauma or injury associated with the athletic cycling competition.

I hereby waive, release and discharge for myself, my heirs, executors, administrators, legal representatives, assigns, and successors in interest (hereinafter collectively ‘successors’) any and all rights and claims which I have or which may hereafter accrue to me against the officers and members of SCVS, property owners, law enforcement agencies, all public entities, special districts, and properties (and their respective agents, officials, and employees) through or by which the events will be held for 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 riding and training.

I agree it is my sole responsibility to be familiar with the ride course, and SCVS Club Rules, and all rules pertaining to riding on public roads. I understand and agree that situations may arise during the ride which may be beyond the immediate control of the club officials or organizers, and I must continually ride so as to neither endanger myself nor others. I accept responsibility for the condition and adequacy of my bike and equipment. I will ride wearing a helmet that satisfies the requirements of the USCF Racing Rules and that can protect against serious head injury, and assure all responsibility and liability for the selection of such a helmet. I do not have any physical or medical conditions which, to my knowledge, would endanger myself or others if I participate in any SCVS event.

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 my claim in contravention of this agreement, I or my successors shall be liable for the expenses (including legal fees) incurred by the other party or parties in defending, unless the other party or parties are finally adjudged liable on such claim for willful and wanton negligence. This agreement may not be modified orally, and a waiver of any provision shall not be construed as a modification of any other provision herein or as consent to any other provision herein or as a consent to any subsequent waiver or modification.

Privacy Statement: SCVS collects personally identifiable information when you apply for membership. When you apply for a SCVS membership, we ask for your name, e-mail address, birth date, address, phone numbers, emergency contact information. Once you have become a SCVS member, you are not anonymous to us.

SCVS uses information for three general purposes: to send you e-mail regarding club activities, to contact you about special events, and to provide club members a contact list.

SCVS will not sell or rent your personally identifiable information to anyone. You may request withholding of your personally identifiable information from distribution to club members on the contact list by sending an e-mail or letter to SCVS.

SCVS may amend this policy from time to time. If we make any substantial changes in the way we use your personal information we will notify you by posting a prominent announcement in our newsletter.

PARENT OR GUARDIAN OF A MINOR: I as parent or guardian of the below named minor, hereby give my permission for my child to participate in the event, and further agree, individually and on behalf of my child or ward, to the terms of the above.

First Name: Last Name: Website Username: Date of Birth: Address: E-Mail: City: State: Zip: Phone#: Contact In Case of Emergency: Emergency Phone#:

Indicate your interest in the following (check all that apply): Advocacy Education Events Media Membership   Membership Type: New Member($35) Renew Member ($25) New Family ($60) Renew Family ($45)