August 20, 2016

DEERFIELD DIRT ROAD RANDONNEE (D2R2)

WAIVER RELEASE FORM

Franklin Land Trust (FLT) of Shelburne Falls, Massachusetts, Pioneer Gardens, Inc., Frontier Regional High School and Green River Village Preservation Trust and all others affiliated with the event. Release and Waiver of Liability, Assumption of Risk, and Indemnity and Parental Consent Agreement ("Agreement") 

IN CONSIDERATION of being permitted to participate in any way in the “Deerfield Dirt Road Randonnee” (D2R2) to benefit the Franklin Land Trust” (the “Activity” which includes: registration on property owned by Pioneer Gardens,  a Long Distance recreational ride throughout western franklin county and SOUTHERN vermont, returning to event headquarters on mill village road with post ride showers at Frontier Regional High School, LUNCH AT THE GREEN RIVER VILLAGE PRESERVATION TRUST and a dinner AND camping on land owned by Pioneer gardens as an option for event participants) I, for myself, my personal representatives, assigns, heirs, and next of kin: 

1. ACKNOWLEDGE, agree and represent that I understand the nature of the Activity 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 on August 20, 2016 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 the conditions to be unsafe, I will immediately discontinue further participation in the Activity. 

2. FULLY UNDERSTAND that: (a) Running the participation as a cyclist in a long distance recreational ride traveling over a majority of dirt roads with steep elevation changes CAN INVOLVE RISKS AND DANGERS OF SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS, AND DEATH ("RISKS"); (b) these Risks and dangers may be caused by my own actions or inactions, the actions or inactions of others participating in the Activity, the condition in which the Activity takes place, or THE NEGLIGENCE OF THE "RELEASEES" NAMED 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 RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I incur as a result of my participation in the Activity. 

3. HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE the Franklin Land Trust, the FLT D2R2 Planning Committee, Pioneer Gardens, Inc., Frontier Regional High School and Green River Preservation Trust, their respective administrators, directors, agents, officers, volunteers, employees, event checkpoint managers and safety organizers,  other participants, any sponsors, advertisers, and if applicable, owners and lessors of premises on which the Activity takes place, (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 INDEMNIFY 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 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 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.

PRINTED NAME OF

PARTICIPANT:_____________________________________________________Date:___________________ 

PARTICIPANT SIGNATURE

(if over age 17):_____________________________________________________________________________ 

AND I, THE MINOR'S PARENT AND/OR LEGAL GUARDIAN, UNDERSTAND THE NATURE OF THE “ACTIVITIES”  (the “Activity” which includes: registration on property owned by Pioneer Gardens,  a Long Distance recreational ride throughout western franklin county and SOUTHERN vermont, returning to event headquarters on mill village road with post ride showers at Frontier Regional High School, LUNCH AT THE GREEN RIVER VILLAGE PRESERVATION TRUST and a dinner AND camping on land owned by Pioneer gardens as an option for event participants) for event participants AND THE MINOR'S EXPERIENCE AND CAPABILITIES AND BELIEVE THE MINOR TO BE QUALIFIED TO PARTICIPATE IN SUCH ACTIVITY. I HEREBY RELEASE, DISCHARGE, COVENANT NOT TO SUE, AND AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS EACH OF THE RELEASEES FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, AND DAMAGES ON THE MINOR'S 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 FURTHER AGREE THAT IF, DESPITE THIS RELEASE, I, OR THE MINOR, OR ANYONE ON THE MINOR'S BEHALF MAKES A CLAIM AGAINST ANY OF THE RELEASEES NAMED ABOVE, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES FROM ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS LIABILITY, DAMAGE, OR COST ANY MAY INCUR AS THE RESULT OF ANY SUCH CLAIM.

PRINTED NAME OF

PARENT/GUARDIAN:________________________________________________Date:________________                  

PARENT/GUARDIAN SIGNATURE

(if participant is under the age of 18):_________________________________________________________