The following "Event Assumption of Risk, Declaration, Waiver, Indemnity
Release Form" has been approved by the Namibian Cycling Federation (the "NCF").
In consideration of the issuance of a license to me by one or more Releasees or the acceptance
application for entry in an event ("event") regulated by or associated with the NCF, I hereby freely agree to
make the following contractual representations and agreements:
1. Assumption of risk
1.1 I acknowledge that I have been advised that and am aware that participation in the event
risks of injury, trauma, harm and damage to me, my property, other participants, spectators
other persons attending or in the vicinity of the event and with this knowledge
I voluntarily participate
in the event fully accepting all such risks if they arise which may result in personal injury, death and damage.
1.2 I acknowledge that cycling is an inherently dangerous sport and fully realize the dangers of participating in this event, whether as a rider, official, coach,
spectator, or otherwise, and fully assume the risks associated
with such participation
including, by way of example, and not limitation: dangers associated with man-made and natural jumps; the
dangers of collision with pedestrians, vehicles,
other riders, and fixed or moving objects; the
dangers arising from surface hazards, including pot holes, equipment failure, inadequate safety equipment, use of equipment or materials provided by the event organizer and others,
releasees' own negligence, the negligence
others and weather conditions; and the
possibility of serious
physical and/or mental trauma or injury, or death associated
with the event, for myself, my heirs, executors, administrators, legal representatives,
successors in interest (collectively "successors").
2. Representations and Warranties
2.1 I agree it is my sole responsibility to be familiar with the event course and agenda, the releasees'
rules, and any special regulations for the event and agree to comply with all such rules and regulations.
2.2 I have read it carefully before signing, and
I understand what it means and what I
am agreeing to by signing.
have no physical or medical condition which would endanger myself or others if I
participate in this event.
2.4 I understand and agree that situations may arise during the event which may be beyond the
control of the releasees, and I must continually ride and otherwise participate so as to neither endanger myself nor others. I accept responsibility for the condition and
adequacy of my equipment,
provided for my use, and my conduct in connection with this
event. I will wear a helmet which satisfies the requirements
of the releasees' racing rules or
regulations and that can protect against serious head injury, and assume all responsibility and liability for the selection of such a helmet and any modifications and attachments made thereto.
2.5 I understand and agree
that the UCI
Anti-Doping Rules apply to
me and that it is
my responsibility to comply with those rules. I agree to submit to drug testing and understand
the use of methods or substances
prohibited by the applicable anti-doping rules would
me subject to penalties including, but not limited
disqualification and suspension. If
it is determined that I may have committed a doping violation, I agree to submit to the
results management authority of the UCI and my national federation.
agree, for myself and my successors, that the above representations are contractually binding, and are not mere
recitals, and that should I or my successors assert a claim
to what I have agreed to in this contract,
claiming party shall be liable for the expenses
(including legal fees) incurred by the releasees in defending the claims.
2.7 This contract may not be modified orally, and a waiver or modification
of any provision shall not be construed as a waiver or modification of any other provision herein or as a consent to any subsequent waiver or modification. Every term and provision of this contract is intended
to be severable. If any
or more of them is found to be unenforceable or invalid, that
affect the other terms and provisions, which shall remain binding and enforceable.
2.8 This release is a contract with legal and binding consequences
it applies to all races and activities entered at the event, regardless whether or not listed above.
3. Consent to treatment
3.1 I agree that if I suffer injury the releasees' may at my expense arrange for me to receive
medical treatment and emergency evacuation services as the releasees' deem appropriate and I understand that any personal injury that I incur may be worsened or compounded by
only my actions but by the actions, omissions or negligence of others.
3.2 I agree that I am responsible for my own medical and
ambulance insurance as well as insurance for my personal belongings.
4. Release and Discharge
I hereby unconditionally release and forever discharge from all liability the organizer of this event,
the Namibian Cycling Federation, and
their respective agents, insurers, employees, volunteers, members,
clubs, officials, sponsors, event directors, local associations, and affiliates (collectively "releasees"), from any and all claims, suits, demands, expenses, costs, damages or proceedings
of any nature
arising and resulting from any personal injury, death, property damage or loss sustained
me as a result of my participation in the event and I hereby agree not to take legal action of any
against the organizer in connection with the event or my participation in it.
5.1 I hereby unconditionally indemnify and hold harmless, and shall keep indemnified and held
harmless, and promise not to sue, the releasees and all sponsors, organizers
promoting organizations, property owners, law enforcement agencies, public entities, local authorities, property owners that are in any manner connected with this event, and their respective
agents, officials, and employees through or by which the event will be held, (the foregoing are also collectively deemed to be releasees), from any and all rights and claims including claims arising from the releasees' own negligence
to the maximum extent permitted by law, which I have or which may hereafter accrue to me and from any and all damages which may be
directly or indirectly in connection with, or arising out
participation in or association with the event, or travel to or return from the event.
5.2 I hereby unconditionally indemnify and hold harmless, and shall keep indemnified and held
harmless the releasees and all sponsors, organizers and promoting organizations, property
owners, law enforcement agencies, public entities, local authorities, and properties owners that are in any manner connected with this event, as a result of, or arising out of, whether
directly or indirectly, my arrival and departure there from, attendance
at registration, prize-
giving or other function thereof, any
loss or damage to bicycles or other equipment, however
such loss or damage may arise regardless of whether or not the same shall have b een caused
directly or indirectly by the negligence, albeit gross, of one or more of
all the aforementioned parties as
6. Medical Information
I consent to the release by any third party to releasees and their insurance carriers
of my name and medical information that may relate solely to any injury or death I may suffer arising from the event.
7. Photographic Material
7.1 I hereby grant permission to the rights of my image, likeness and sound of my voice as
recorded on audio, video or photograph without
payment or any other consideration.
understand that my image may be edited, copied, exhibited, published or distributed and
waive the right to inspect or approve
finished product wherein my likeness
appears. Additionally, I waive any
right to royalties or other compensation arising or related to the use
of my image or recording. I also understand
this material may be used in within an unrestricted
7.2 By signing this release, I understand this permission signifies that photographic or video
recordings of me may be electronically displayed via the Internet or in a public setting.
7.3 There is no time limit on the validity of this release nor is there any geographic limitation
on where these materials may be distributed.
7.4 This release applies to photographic, audio or video recordings collected as part of the event
I am entering.
7.5 By signing this form I acknowledge that I have completely read and fully understand the above release and agree to be bound thereby. I hereby
release any and all claims against any
person or organization utilizing this material.
I attest that I am twenty one (21) years of age or older (or that if I am younger, my parents or legal guardian have executed this waiver below), and that I am physically fit and sufficiently trained to participate in
activities associated with the
or events and my
program or events is voluntary.
9. Age Consent And Release Of Parent\Legal Guardian
9.1 I am the parent or legal guardian of (child). My child is fit for the event, and I consent to my
9.2 I have read and I understand the above contract.
9.3 In consideration of allowing my child to participate, I consent to the contract and agree that it’s terms shall likewise bind me, my child, and our heirs, legal representatives, and assignees. I hereby release and shall defend, indemnify and hold harmless the releasees from every
that I or my
the releasees (including
reasonable legal fees and costs) as a direct or indirect result of injury or death to me or my
loss or damage to my
or my child's property
because of my child's participation in the
event, whether caused by the negligence
of the releasees or others to the maximum extent permitted by law.
promise not to sue releasees on my behalf or on behalf of my child regarding any claim
arising from my child's participation in the event.