WPW RIDE SIGN UP SHEET
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WPW Bicycle Club P.O. Box 99684 Pittsburgh, PA 15233 |
Ride Name __________________________________ Classification: Speed ________ Terrain ________ Distance _______ Day __________ Date __________ Time __________ Quadrant _____________________ Ride Leader _________________________________ Temperature _______ Weather Conditions _________________ Comments: |
RELEASE: In signing this release, I acknowledge that bicycling on public roads is a hazardous activity with risks of injury, and that I voluntarily assume the risks. I understand that the Western Pennsylvania Wheelmen, Ltd., its ride leaders and other members, welcome my participation on this ride, but are not responsible for my safety or liable for any injury that might result. As parent or guardian of a rider under 18 years of age, I agree to indemnify and hold harmless the above mentioned parties from any claim for injury or damages which said minor may sustain. I will obey traffic laws and ride carefully to ensure my own safety as well as the safety of those with whom I share the road. I hereby consent to and permit emergency medical treatment if I am injured.
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Name (Print) |
Name (Signature) |
Member? |
Emergency Phone # |
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Ride leaders are requested to retain sign-up sheets and to send them at the end of the season to WPW Bicycle Club, P.O. Box 99684,Pittsburgh, PA 15233.