Registration

Membership Type *

Calculations

Name of applicant *

Street Address *

Apartment, suite, etc

City

Province

Postal Code

Country

Email Address *

Phone *

Emergency Contact Name *

Emergency Contact Phone *

Emergency Contact Relationship *

Cycling Skill Level *SeriousIntermediateCasualBeginner

I have read and agree to the waiver. *

WAIVER AND RELEASE OF LIABILITY, ASSUMPTION OF RISK, INDEMNITY AND PARENTAL CONSENT AGREEMENT

IN CONSIDERATION of being permitted to be a Participant in any way in Cycle Stratford Inc. sponsored bicycling activities (the “activity” or “activities”), I, for myself, and on behalf of any minor participant, and the heirs, next-of-kin, executors, administrators, successors, assigns, and representatives of them (the “Releasors”):

Accept *

1. ACKNOWLEDGE THAT I UNDERSTAND THE NATURE OF BICYCLING ACTIVITIES AND THAT THE RELEASORS ARE QUALIFIED, IN GOOD HEALTH AND PROPER PHYSICAL CONDITION TO PARTICIPATE IN SUCH ACTIVITY. The Releasors further understand that this activity will be conducted over public roads and facilities upon which hazards are to be expected. The Releasors further agree that if at any time the Releasors deem conditions to be unsafe, the Releasors will immediately discontinue further participation in the activity.

Accept *

2. FULLY UNDERSTAND that a) bicycling involves risks and dangers of serious bodily injury, including, but not limited to, disability and death (the “risks”), b) these risks may be caused by, amongst other things, the Releasors’ negligence, acts or omissions, the negligence, acts or omissions of others, including, but not limited to, the Releasees (as herein defined) and other participants in the activity, and/or the conditions in which the activity takes place, c) other risks may include social or economic losses or other losses not foreseeable at this time, and I fully accept responsibility for such losses.

Accept *

3. HEREBY REMISE, RELEASE, ACQUIT, HOLD HARMLESS, INDEMNIFY, FOREVER DISCHARGE, AND COVENANT NOT TO TAKE LEGAL ACTION against Cycle Stratford Inc., its respective present and former directors, officers, members, agents, servants, independent contractors, employees, volunteers and sponsors (the “Releasees”), from and against all liability, claims, demands, losses or damages which the Releasors, or any of them, may suffer or incur, howsoever caused, whether directly or indirectly, or alleged to be caused by the Releasees including caused by, or arising out of, NEGLIGENCE ON THE PART OF THE RELEASEES.

Accept *

I HAVE READ THIS AGREEMENT AND FULLY UNDERSTAND ITS TERMS AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY AGAINST THE RELEASEES.

I am aware that my participation in the activities does not provide or entitle me to any disability, accident, medical or life insurance coverage.

I agree that I have read and understand the Guidelines and Policies of Cycle Stratford Inc. (see https://cyclestratford.com/guidelines/), including its Ride Ahead Policy and Harassment Policy, and agree to abide by the terms, conditions, and rules laid out in these documents. I also agree that Cycle Stratford Inc. may prohibit my participation in any program for inappropriate behavior or failure to comply with any of the above.

I hereby grant permission to Cycle Stratford Inc. to use my likeness in photographs or recordings of my participation.

Amount Due

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Payment Method *Interac e-TransferPaypal (including Credit Cards)Cycle Stratford prefers Interac e-Transfer however payment by Paypal is still available

Interac e-Transfer Instructions

Please do not fill in this field.