Central Iowa Charters Registration Form

I know and understand that cycling and its related events involve potentially hazardous or dangerous activities. I participate in cycling and other related events with the Central Iowa Charters out of my own free will and choice. I fully accept and assume all risks, whether before, during or after these events. These include, without limitation, physical injury, mental injury, emotional distress, trauma, sickness, illness, death, contact with other participants, equipment failure, inadequate safety equipment, the effects of weather including extreme temperatures or conditions, traffic contact with motor vehicles of all types and descriptions, collision with other riders or fixed objects, the condition of the road, camping, negligence of others and participating in events, including those along the route. All risks are known and appreciated by me and I waive any and all specific notice of the existence of them. I assume and will pay my own medical and emergency expenses in event of injury, illness, or other incapacity regardless of whether I authorized such expenses. I authorize the use and release of personal and medical information in connection with any medical services provided to me.

I realize that bicycling requires physical conditioning. I represent that I am in sound medical condition capable of participating in cycling events with the Central Iowa Charters without risks to others or myself. I have no physical or medical impediment, which would endanger others or myself. I understand and agree that a situation may arise during events, programs and activities that may be beyond the control of the sponsors, promoters, organizers or others or may arise from negligence by them and accept assume all risks of participating and attendance. I will be solely responsible for the condition and adequacy of my bicycle, safety gear and riding equipment. I will ride safely within the limits of my own abilities, my equipment and riding conditions and in a manner that does not endanger either others or myself.

Knowing these facts and in consideration of my entry acceptance, admission to and /or participation in cycling and its related events with the Central Iowa Charters, I for myself, spouse, heirs, next of kin, assigns and anyone acting on my behalf, release, waive, discharge, covenant not to sue or hold the officers, directors, employees, representatives, agents and successors of all any and all rights and/or claims which I have, and/or may have hereafter accrue to me against the sponsors, promoters, board of directors of the Central Iowa Charters, or other sponsors or affiliated organizations and their respective agents, officers and employees for any and all damages, injuries or claims which may be sustained by me directly or indirectly arising out of my participation with the Central Iowa Charters, harmless from any and all claims, demands and actions of any and every kind I have, may have or may hereafter accrue against the released parties directly or indirectly arising out of relating in any respect to my attending or participating in cycling with the Central Iowa Charters and its related events.

I acknowledge that I am signing this agreement freely and voluntarily, and intend by my signature for this to be a complete and unconditional release of all liability to the greatest extent allowed by law. I further acknowledge that no representations, promises, statements or inducements have been made to me other than as set forth in this document. I further agree to indemnify and hold the parties released above harmless from any and all losses, damages, claim and expenses, including attorney fees, arising from or relating in any respect to my participation in cycling and related events with the Central Iowa Charters or my breach of this agreement. The above agreements and representations are my express understandings of the risks and I assume these voluntarily and freely without coercion or duress. This agreement may not be modified orally and may not be waived in any respect.

All matters arising out of this Agreement and my participation in RAGBRAI with the Central Iowa Charters shall be governed by laws of the State of Iowa, without regard to choice of law principles, and shall be within the exclusive jurisdiction of the state and/or federal courts located within Polk County in the State of Iowa and the parties hereby consent to such exclusive jurisdiction and waive objections to venue therein.
accept waiver