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Plymouth County Cyclists
Membership Application Form

 

Plymouth County Cyclists, P.O. Box 511, Le Mars, IA 51031-0511

MEMBERSHIP

TYPES AND PRICES

Good for one year, no fee is charged to member when paying with PayPal

 

     • New/Renewal Membership - $20.00                      (per adult 18 years or older)

     • Youth Membership - FREE

        (under 18 years of age)

     • Lifetime Membership (Couple) - $250

     • Lifetime Membership (Single) - $150

RELEASE AND WAIVER

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

IN CONSIDERATION of being permitted to participate in any way in the Plymouth County Cyclists (hereafter “PCC”) sponsored Bicycling Activities (hereafter “Activity’ or “Activities”) I, for myself, my personal representatives, assigns, heirs and next of kin: 

1. AKNOWLEDGE, agree, and represent that I understand the nature of 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 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) ACTIVITIES INVOLVE RISKS AND DANGERS OF SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS AND DEATH (b) these risks and dangers may be caused by my 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 ECONOMICAL LOSSES either not known to me or not readily foreseeable at this time; and I FULLY ACCEPT ALL SUCH RISKS AND ALL 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 PCC, its respective administrators, directors, agents, officers, volunteers and employees, other participants, any sponsors, advertisers, and, if applicable, owners and lessors of premises on which the Activity takes place, 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, BUT NOT LIMITED TO NEGLIGENT RESCUE; 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 Releasers, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS EACH OF THE RELEASEES from any litigation expenses, attorney fees, loss, liability, damage or cost which may occur as the result of such claim. 

4. HEREBY WAIVE any right to be notified or to inspect or approve the media or any materials that are created using my likeness, now or in the future, whether that use is known or unknown to me. I HEREBY WAIVE any right to royalties or other compensation arising from or related to the use of the media or materials. 

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. I 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. 

NEW OR RENEWING MEMBERSHIP is $20.00(per adult) good for one year.  Auto-renewal is available with PayPal payment.  No fee is charged to the member for use of PayPal.

YOUTH MEMBERSHIP is free(under 18 years of age).

LIFETIME MEMBERSHIP is $150.00 (individual) or $250.00(for a couple) –YOUR NAME WILL BE ADDED TO OUR LIFETIME MEMBERS PLAQUE DISPLAYED AT BIKE CENTRAL IN LE MARS 

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