The following "Event Assumption
of Risk, Declaration, Waiver, Indemnity and 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 of my application for entry in an event ("event")
regulated by or associated with the NCF, I hereby freely agree to and 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 involves significant risks of injury, trauma, harm and damage to me,
my property, other participants, spectators and 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, mechanic,
volunteer, 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, the releasees' own negligence, the negligence of
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, assignees, and
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.
2.3
I 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, any 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 that the use of methods or
substances prohibited by the applicable anti-doping rules would make me subject
to penalties including, but not limited to, 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.
2.6
I 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 contrary to what I have agreed to in this contract,
the 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
one or more of them is found to be unenforceable or invalid, that shall not
affect the other terms and provisions, which shall remain binding and
enforceable.
2.8
This release is a contract with legal and binding consequences and 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 not 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 whatsoever arising and resulting from any personal injury, death,
property damage or loss sustained by me as a result of my participation in the
event and I hereby agree not to take legal action of any kind against the
organizer in connection with the event or my participation in it.
5.
Indemnity
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 and 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 sustained by
me directly or indirectly in connection
with, or arising out of, my 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 set out.
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. I understand that my image may be edited, copied,
exhibited, published or distributed and waive the right to inspect or approve
the 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 that this material may be used in within
an unrestricted geographic area.
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 that 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.
8. Minors
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 all activities associated with the
program or events and my participation in
such 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 child's participation.
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 claim and any
liability that I or my child may
allege against the releasees (including
reasonable legal fees and costs) as a direct or indirect result of injury or
death to me or my child or 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.
9.4 I 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.