Bike MS Waiver

Name*

First NameLast Name

Email*

example@example.com

Birth Date*

MonthDayYear

Name of your specific Bike MS event (e.g. Bike MS: Escape to the Lake, Bike MS: Arizona)*

Date

Calculation

I attest that I am in fact the parent or legal guardian of the above-named participant and am legally authorized to sign on the participant’s behalf. I hereby give my approval to this individual’s participation in Bike MS. I assume all risks and hazards incidental to such participation, and I hereby waive, release, absolve, indemnify, and agree to hold harmless Releasees for any claim arising or any injury to my dependent and from any and all liability, claims, actions, demands, expenses, attorney fees, breach of contract actions, breach of statutory duty or other duty of care, warranty, strict liability actions, and causes of action whatsoever arising out of or connected with my dependent’s participation in Bike MS. I consent to the foregoing and grant permission for my dependent to participate in Bike MS.I attest that my dependent, the above-named participant, is a minimum of twelve (12) years of age as of the date of Bike MS and that my dependent will be accompanied by an adult twenty-one (21) years of age or older (“Temporary Guardian”) throughout his/her participation in Bike MS. I entrust Temporary Guardian with the health and well-being of my dependent throughout the duration of Bike MS.I attest that I, along with my dependent, have read the Society’s safety guidelines, including, but not limited to, the Safety in Group Cycling brochure and fully understand and will comply with such guidelines. I acknowledge I have carefully read, accept, and agree to the terms of this Waiver, and know and understand its contents and I sign the same on my own free act and deed.

Parent/Guardian's Full Name:*

First NameLast Name

Adult the dependent will be accompanied by during the event:*

First NameLast Name

Please read the Bike MS Release and Waiver of Liability.

I acknowledge and represent that I have carefully read and understand all terms of the Waiver. I am legally competent to sign this agreement for myself and/or on behalf of the minor listed in the Registration.

Please type full name to sign.*

Bike MS Waiver

Participant Information