TOP OF MAINE
MOUNTAIN BIKE RACE
TOP OF MAINE
MOUNTAIN BIKE RACE
ADDRESS:______________________________ DATE OF BIRTH:_____________________
TOWN/ST.:______________________________ PHONE #:___________________________
Identification of Risk: I,(participant)_______________________ understand that there are inherent and other risks involved in sport, that injuries are a common and ordinary occurrence that Mountain biking involves risks of serious injury, including permanent disability and death. I understand that these injuries might result not only from my actions, but the actions, inactions, or negligence of others.
Assumption of Risk: I agree that I am responsible for my safety while participating in Mountain Biking competition associated with the Madawaska Recreation Department, and that such responsibility includes being physically and psychologically prepared to participate, familiarizing myself with the trail before beginning. I assume all risks, both known and unknown, connected with my participation.
Waiver: Being aware of the risks and willing to assume them, I hereby release from any legal liability, Town of Madawaska, recreation department, employees, sponsors, owners/lessors of used property and trails from liability for injury or death to myself or to any other person or damage to property resulting from my participation in mountain biking and from any claim based upon negligence, breach of warranty, contract or other legal theory, accepting myself the full responsibility for any and such injury, death or damage which may result. I intend for this waiver and release to also apply to my relatives, personal representatives, heirs, beneficiaries, next of kin, and assigns. This agreement is governed by the applicable law of Maine. If any part of this agreement is determined to be unenforceable, all other parts shall be given full force effect. This waiver does not release acts of gross negligence nor willful and wanton misconduct of any part.
Insurance: I currently have and agree to maintain throughout the time I participate, sufficient medical and accident insurance. I understand that this is my responsibility and release any one else from providing it for me.
I have read this agreement carefully, understand that I give up substantial rights by signing it, and sign it voluntarily.
_______________________________________________ ____________________________
Participant signature Date
For participants under age 18:
I consent to the above person’s participation in Top of Maine Bike Race. I acknowledge, for myself and the above person, that we assume all risks, known and unknown, and waive all claims in advance. I have read this agreement carefully, understand that the above person and I give up substantial rights by signing it, and sign voluntarily.
______________________________________ _________________________________ _________________
Parent/Guardian full name (in print) Parent/Guardian signature Date
Please Fill in the circle of the race you are registering for:
Ø Multiple Race Divisions
o 10:00 am: Ages 4-8 and 9-12
o 11:00 am: Ribbon Race (5 miles) Ages 13 & Older
o 11:15 am: Money Race (15 miles) for anyone interested!
Ø Cash Prizes and Awards
o Ribbon Races
§ Ribbons and Random Drawing
o Money Race
§ Male and Female Prizes $300 for 1st, $200 for 2nd, $100 for 3rd
Ø Free T-Shirts for the first 75 registrations
WATER BOTTLES FOR EVERYONE!
Registration:
$5 for Individual $12 for Family $15.00 Pre-registration $20.00 Day of Race
For more information contact: Madawaska Recreation Department 728-3604