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Waiver and
Release Form MUST be signed & returned prior to the invoice
being paid, and certainly prior to the tour. This is for the obvious protection of our small
business which cannot be subjugated to abilities or inabilities of motorcycle the
rider and passengers. Complete this form and fax it to the phone number sent to you at the time of registration or mail it in. INTRODUCTION: ( WAIVER & RELEASE AGREEMENT ( I agree to ride my motorcycle that I may own or have rented or borrowed, within my riding ability and agree to not be influenced by any group or pack mentality to ride faster than is within my ability or the limits of what is considered safe riding conditions. Nor will I be influenced by riding displays by my fellow tour participants nor tour guides that could be considered unsafe. I fully understand that I may encounter riding conditions and roads that I have not traveled before, and have no prior knowledge of, and therefore will ride within a manner that is considered safe for those riding conditions. Furthermore, I agree that I will not in any circumstance ride the motorcycle on a Vegas Valley Motorcycle Tour, beyond what is commonly considered a safe manner. I hereby release, hold harmless, and promise not to sue Vegas Valley Motorcycle Tours, its officers, owners, directors, employees, or agents (collectively "releases") with respect to any and all bodily injury and/or other loss resulting from my participation in a Vegas Valley Motorcycle Tour whether as passenger or operator of a motorcycle, whether caused by the negligence of the releasees or otherwise during any respect associated with riding upon my own or my rental motorcycle. In addition, by payment of a deposit, and/or my signature on this form, I certify that I do not have any physical or mental condition or disability that would create a hazard for me or my fellow tour participants. I certify that I am over 21 years of age and am in possession of a valid motorcycle operator's permit endorsement on my valid driver's license. I, the tour participant, be it motorcycle operator or passenger, have read the tour descriptions, Terms and Conditions and this Waiver & Release Agreement and will abide by all terms as stated herein or published within Vegas Valley Motorcycle Tours printed material. I hereby agree this waiver or release shall be binding upon and enforceable against me, my personal representatives, spouse, assigns, heirs, and next of kin without limitation. I, the tour participant acknowledge and take full responsibility for any and all passengers. I affirm that I have not obtained or am not relying on any verbal or written representation of Vegas Valley Motorcycle Tours as a basis for executing this Waiver and Release. I have read and understand the terms of this release and waiver of responsibility. I am about to sign and further understand that Vegas Valley Motorcycle Tours cannot accept any tour participant, be it operator or passenger, without a duly signed release and waiver form. I understand clearly that I have given up substantial rights by signing this release and wavier of responsibility and have signed it freely and voluntarily without any inducement, assurance, or guarantee being make to me and intend my signature to by a complete and unconditional release of all liability to the greatest extent allowed by law. Please Initial: Photographs
Print Name ___________________________________ Date: __________________ Witness Signature _____________________________ Print Witness Name ____________________________ Date: ___________________ (Signatures must be witnessed.) Relation: ______________________________________ Phone (home): __________________________________ Phone (work): ___________________________________ Phone (alt/cell): ________________________________ Vehicle Insurance Carrier: _________________________ Policy #: _______________________________________ Health Insurance Carrier: _________________________ Policy #: _______________________________________ Please list any allergies, medicines taken regularly or medical conditions? Print: __________________________________________________________________________ If you have a severe allergy to insect stings, do you carry an "Anakit"?
_____________________ Emergency Contact: _____________________________ Relation: ______________________________________ Phone (home): __________________________________ Phone (work): ___________________________________ Phone (alt/cell): ________________________________ Vehicle Insurance Carrier: _________________________ Policy #: _______________________________________ Health Insurance Carrier: _________________________ Policy #: _______________________________________ Print: __________________________________________________________________________ If you have a severe allergy to insect stings, do you carry an "Anakit"? _____________________ |
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Updated 05/06/2008 - 5:30pm |
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