Name *
Date you wish to ride
Date you wish to ride
Which Ride would you like to do?
For example: do you like hills, flat roads, easy cycling, fast cycling, regular breaks, pictures, coffee etc.
Place a tape measure inside the drive side crank arm and measure straight up the seat tube to the top of the saddle.
I supply Look keo pedals and Shimano pedals, if you use another brand of pedal you will need to bring them with you.
Participant Release and Waiver IN CONSIDERATION of being given the opportunity to participate in The Domestique Rides (the “Activity”), I agree to 1. I KNOW THIS IS DANGEROUS. I fully understand that: (a) CYCLING IS INHERENTLY DANGEROUS AND INVOLVES RISKS AND DANGERS OF SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS AND DEATH ("Risks"); (b) Risks may include, but are not limited to collision with pedestrians, vehicles, other riders, or fixed or moving objects, and dangers arising from surface hazards, equipment failure, weather, inadequate safety equipment, use of equipment or materials provided by the Releasees or others; (c) these Risks may be caused by my own actions, or inactions, the actions or inactions of others participating in the Activity, the area and conditions in which the Activity takes place, or my negligence or the negligence of the Releases names below; and (d) there may be other Risks not known to me or not readily foreseeable at this time. I FULLY ACCEPT AND ASSUME ALL SUCH RISKS, KNOWN AND UNKNOWN, AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I INCUR AS A RESULT OF MY PARTICIPATION IN THE ACTIVITY. 2. I’LL LOOK AROUND AND USE GOOD JUDGMENT. I will examine and inspect the Activity in which I participate. If I observe any condition, which I consider to be unacceptably hazardous or dangerous, I will notify the proper authority in charge of the Activity and will refuse to take part in the Activity until the condition has been corrected to my satisfaction. 3. I WON’T SUE. I RELEASE, DISCHARGE, AND COVENANT NOT TO SUE THE DOMESTIQUE LLC., THEIR ADMINISTRATORS, DIRECTORS, AGENTS, OFFICERS, VOLUNTEERS AND EMPLOYEES, OTHER PARTICIPATING EVENT ORGANIZERS, ANY SPONSORS, ADVERTISERS, AND IF APPLICABLE, OWNERS AND LESSORS OF PREMISES, ON WHICH THE ACTIVITY TAKES PLACE, (each, including The Domestique, the “Releasees”) from all liability, claims, demands, losses or damages on my account, now or hereafter accrued, which are caused or allege to be caused in whole or in part by my participation in, association with or travel to and from the Activity, including my negligence, the negligence of the Releasees or otherwise, or negligent rescue operations; and I further agree that if, despite of this Release, 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’s expenses, attorney fees, loss, liability, damage, or cost which any may incur as a result of such claim. 4. I’M READY FOR IT; YOU CAN SHARE MY INFORMATION. I understand that participation in the Activity may be extremely demanding both mentally and physically. I am qualified, in good health, and in proper physical and mental condition to participate in the Activity. I consent to the release by any third party to the Releasees and their insurance carriers of my name and medical information that may relate solely to an injury I may suffer arising from the Activity. 5. YOU CAN DO WHATEVER YOU WANT WITH MY IMAGE. As participant in the Activity and in any facets as to which my participation may be included, I hereby grant The Domestique LLC., the irrevocable and unrestricted right and permission to copyright, in name or otherwise, and use, re-use, publish, and re-publish of me or in which I may be included, in whole or in part, or composite or distorted in character or form, without restriction as to changes or alterations, in conjunction with my own or a fictitious name, or reproductions thereof in color or otherwise, made through any medium, and in any and all media now or hereafter known for illustration, promotion, art, editorial, advertising, trade, or any other purpose whatsoever. I also consent to the use of any printed matter in conjunction with any of the 6. I KNOW THIS RELEASE IS FOR REAL. I am of full age and have the right to contract in my own name. I have carefully read this Release prior to its execution, I am fully familiar with it and I UNDERSTAND THAT I AM GIVING UP SUBSTANTIAL LEGAL RIGHTS. This release shall be binding upon me and my heirs, executors, administrators, legal representatives, successors-in-interest, and assigns. 7. OTHER BORING LEGAL STUFF. This Release shall be governed by the laws of the State of New York, exclusive of its conflicts of laws principles. This Release shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. This Release may only be modified in a writing signed by the participant and The Domestique. If any of the terms of this Release are found by a court of competent jurisdiction to be unenforceable or invalid, the remaining terms shall not be affected. Section headings are for convenience only! PRINT NAME: ____________________________ PRINT EMAIL: ___________________________ SIGNATURE: _____________________________ DATE: __________________________________ EMERGENCY CONTACT: NAME: __________________________________ PHONE: _________________________________!
Yes I have read and agree to The Domestique Terms & Conditions *