North Carolina Bicycle Club, Inc.
1998 Summer Rally Registration Form

Date: Sunday, July 19th, 1998 - rain or shine
Time: Registration starts at 7:00am, all rides start at 8:00am
Place: Spa Health Club in MacGregor Village in Cary
Cost: $10.00 for NCBC members, $15.00 for non-members (includes a T-shirt while they last)
Course: Wake and Chatham counties; challenging hills
More info: See the NCBC web page at www.NCBikeClub.org
                                                                  NCBC
Name_____________________________________ Age_____ Sex [ ]M [ ]F  Member? [ ]Y [ ]N

Address____________________________________________________________________________
                                                Home               Work
City____________________ State_____ Zip________ Phone_____________ Phone___________

E-Mail Address_____________________________________________________________________

Emergency Contact_________________________________________________ Phone___________

Event [ ] 50K (31 miles)  [ ] 100K (62 miles)
Please bring this completed form with you to speed registration. Make checks payable to NCBC.
You must read and sign the liability agreement on the second page of this form.

If you wish to join the NCBC, please complete this section
I am interested in: (please check all that apply)
Ride types:               Miles per trip            Average speed (mph)
[ ] Day rides             [ ]  5 to 10              [ ] 10 to 12
[ ] Touring               [ ] 10 to 20              [ ] 12 to 14
[ ] Commuting             [ ] 20 to 30              [ ] 14 to 16
[ ] Tandem riding         [ ] 30 to 40              [ ] 16 to 18
[ ] Mountain bike rides   [ ] 50 to 100             [ ] 18 to 20
[ ] Overnight rides       [ ] 100+                  [ ] 20+

I am interested in assisting with: (please check all that may apply)
[ ] Leading day rides     [ ] Educational programs  [ ] Newsletter mailing
[ ] Leading night rides   [ ] Newsletter articles   [ ] Social events
[ ] Driving SAG wagon     [ ] Newsletter artwork    [ ] Group cooking
[ ] Slide presentations   [ ] Newsletter layout     [ ] Club officer


Occupation______________________________________________________________________

Interests_______________________________________________________________________

Suggestions_____________________________________________________________________

Note:  Dues are $15.00 per year, for either single or family membership.

LEAGUE OF AMERICAN WHEELMEN d/b/a LEAGUE OF AMERICAN BICYCLISTS ("LAB")
RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK,
AND INDEMNITY AND PARENTAL CONSENT AGREEMENT ("AGREEMENT")

IN CONSIDERATION of being permitted to participate in any way in North Carolina Bicycle Club, Inc. ("Club") sponsored Bicycling Activities ("Activity") I, for myself, my personal representatives, assigns, heirs, and next of kin:

1. ACKNOWLEDGE, agree, and represent that I understand the nature of Bicycling Activities and that I am qualified, in good health, and in proper physical condition to participate in such Activity. I further acknowledge that the Activity will be conducted over public roads and facilities open to the public during the Activity and upon which the hazards of travelling are to be expected. I further agree and warrant that if at any time I believe conditions to be unsafe, I will immediately discontinue further participation in the Activity.

2. FULLY UNDERSTAND that: (a) BICYCLING ACTIVITIES INVOLVE RISKS AND DANGERS OF SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS, AND DEATH ("RISKS"); (b) these Risks and dangers may,be caused by my own actions or inactions, the actions or inactions of others participating in the Activity, the condition in which the Activity takes place, or THE NEGLIGENCE OF THE "RELEASEES" NAMED BELOW; (c) there may be OTHER RISKS AND SOCIAL AND ECONOMIC LOSSES either not known to me or not readily foreseeable at this time; and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I incur as a result of my participation or that of the minor in the Activity.

3. HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE the Club, the LAB, their respective administrators, directors, agents, officers, members, volunteers, and employees, other participants, any sponsors, advertisers, and, if applicable, owners and lessors of premises on which the Activity takes place, (each considered one of the "RELEASEES" herein) FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON MY ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE " RELEASEES " OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS; AND I FURTHER AGREE that if, despite this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT 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 expenses, attorney fees, loss, liability, damage, or cost which any may incur as the result of such claim.

I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND -ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND HAVE SIGNED IT FREELY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT.


Participant's signature ________________________________________ Date____________
(only if age 18 or over)

MINOR RELEASE

AND I, THE MINOR'S PARENT AND/OR LEGAL GUARDIAN, UNDERSTAND THE NATURE OF BICYCLING ACTIVITIES AND THE MINOR'S EXPERIENCE AND, CAPABILITIES AND BELIEVE THE MINOR TO BE QUALIFIED, IN GOOD HEALTH, AND IN PROPER PHYSICAL CONDITION TO PARTICIPATE IN SUCH ACTIVITY. I HEREBY RELEASE, DISCHARGE, COVENANT NOT TO SUE, AND AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS EACH OF THE RELEASEE'S FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON THE MINOR'S ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE "RELEASEES" OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS AND FURTHER AGREE THAT IF, DESPITE THIS RELEASE, I, THE MINOR, OR ANYONE ON THE MINOR'S BEHALF MAKES A CLAIM AGAINST ANY OF THE RF,LEASEES NAMED ABOVE, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES FROM ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS LIABILITY, DAMAGE, OR COST ANY MAY INCUR AS THE RESULT OF ANY SUCH CLAIM.


Printed name of parent/guardian__________________________________________________

Parent/guardian signature_______________________________________ Date____________
(only if participant is under the age of 18)