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In consideration of being allowed to participate in any way in the La Grind Gravel Stage Race program, its related

events and activities, I, (name of participant) , the undersigned, acknowledge, appreciate, and agree that:

1. The risk of injury from the activities involved in this program is significant, including the potential for

permanent paralysis and death, and while particular skills, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and,

2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF

ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for

my participation; and,

3. I willingly agree to comply with the stated and customary terms and conditions for participation. If,

however, I observe any unusual significant hazard during my presence or participation, I will remove myself

from participation and bring such to the attention of the Company immediately; and,

4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY

RELEASE, INDEMNIFY, AND HOLD HARMLESS High Gear Cyclery/Handlebars of Hope and La Grind Gravel Stage Race, their

officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers,

and, if applicable, owners and lessors of premises used for the activity ("Releasees"), WITH RESPECT TO

ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property associated with

my presence or participation, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES

OR OTHERWISE, to the fullest extent permitted by law.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.