Sussex Cyclists, Inc.	

Membership Form & Release


Name (please print)  ________________________________________

Address              ________________________________________

                     ________________________________________

Phone Number         __________________Cell _________________

Email address        _________________________________________


		               	Committee Participation

Please sign me up to work on the:

___    Advocacy Committee (promotes safe cycling and adequate riding facilities)
___    Membership Committee (recruit members and publicize club activities)
___    Ride Committee (plan, map and lead rides)
___    PR (promote Sussex Cyclists and help membership committee recruit members)
___    Social Activities (plan and execute social events)
___    Sag Support (assist riders in distress while on rides)

I would like to participate in other ways such as ____________________________________________


				Other Information

I have experience leading rides (circle one)     Y    N
My usual average riding speed is approximately_____ mph.
My comfortable riding distance is approximately____ miles.
I prefer to ride on ____ weekdays _____ weekends AM ___ PM___


Send signed and completed form with a check payable to Sussex Cyclists, Inc. for
$10.00 to:        

Sussex Cyclists, Inc.		
P.O. Box 204
Rehoboth Beach, DE 19971
														

													
													
													
					
					
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Release and Waiver of Liability, Assumption of Risk, and Indemnity Agreement 
("Agreement")

In consideration of being permitted to join and participate in the 
Sussex Cyclists, Inc. sponsored Bicycling Activities ("Activity"), I, for myself, 
my personal representatives, assigns, heirs, and next of kin:

1) ACKNOWLEDGE, agree, and represent that I understand the nature of Bicycling 
Activities and that I am qualified, in good health, and in proper physical 
condition to participate in such Activity.  I further acknowledge that the 
Activity will be conducted over public roads and facilities open to the public 
during the Activity and upon which the hazards of traveling are to be expected.  
I further agree and warrant that if, at any time, I believe conditions to be 
unsafe, I will immediately discontinue further participation in the Activity.

2) FULLY UNDERSTAND that: (a) BICYCLING ACTIVITIES INVOLVE RISKS AND DANGERS 
OF SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS AND DEATH 
("Risks"); (b) these Risks and dangers my be caused by my own actions, or 
inactions, the actions or inactions of others participating in the Activity, 
the conditions under which the Activity takes place, or THE NEGLIGENCE OF THE 
"RELEASEES" INDICATED BELOW; (c) there may be OTHER RISKS AND SOCIAL AND 
ECONOMIC LOSSES either not known to me or not readily foreseeable at this time, 
and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, 
COSTS, AND DAMAGES  I may incur as a result of my participation in the Activity 
or that of the minor.

3) HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE Sussex Cyclists, Inc., 
their administrators, directors, ride leaders, volunteers, agents, officers, 
members and employees, other participants, any sponsors or advertisers, (each 
considered one of the "RELEASEES"  herein) FROM ALL LIABILITY, CLAIMS, DEMANDS, 
LOSSES, OR DAMAGES ON MY ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN 
PART BY THE NEGLIGENCE OF THE "RELEASEES" OR OTHERWISE, INCLUDING NEGLIGENT 
RESCUE OPERATIONS; AND I FURTHER AGREE  that if, despite this RELEASE AND 
WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT  I, or anyone 
on my behalf, makes a claim against any of the "Releasees",  I WILL INDEMNIFY, 
SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES from any litigation expenses, 
attorney fees, loss, liability, damage, or cost which any may incur as a result 
of such claim.

I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE 
GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND WITHOUT 
ANY INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND 
UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND 
AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THE BALANCE, 
NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT.

							Date: __________________

Member/participant signature: _________________________________________

Signature of Parent or Guardian if member/participant is under the age of 18: 

________________________________________