Ride 4 Autism 2018 Registration

The Cross Bearers MM is a 501-C3 Organization. All Charitable Donations are Tax Deductable




As consideration for being allowed to participate in the “Ride 4 Autism 2018” event:
1. I acknowledge that any motorcycle activity is a potentially hazardous activity which can be a test of a person’s physical and mental limits and carries with it the potential for death, serious injury and property loss. The risks include, but are not limited to those caused by nature to include terrain, temperature and overall weather conditions. This also includes the condition of the riders’ equipment, vehicular traffic and the actions of other people. These risks are not only inherent to riders, but are also applicable to their passengers. Knowing this, I hereby assume all of the risks of participation in all manners in this event. I realize that liability for incidents during this event could be passed to the persons or entities organizing or conducting this event and hereby release them of all possible liability. I certify I am at least 18 years old. I agree and forfeit all rights to sue or hold them liable and so, I agree to pay all court costs and all attorney fees that may result from any actions by me to seek damages, whether civil or otherwise.

2. I certify that I am physically fit and have no known knowledge of any physical or mental impairment and that I am physically and psychologically prepared to participate in this event. I acknowledge that this Accident Waiver and Release of Liability form will be used by the Cross Bearers Motorcycle Ministry; the organizers of the event in which I am participating to refute any claims I make against them. I also acknowledge that it will govern my actions and fulfill my responsibilities at this event to be in accordance with a reasonable person behavior pattern. I certify that I am not under the influence of any narcotic, alcohol or other mind altering drug that may impair my understanding or judgment. I will not at any time during the event attempt to operate my motorcycle while under the influence of any narcotic, alcohol or drug. I certify that I have current and adequate insurance in accordance with the laws of the state in which my vehicle is registered to cover all medical claims, the motorcycle(s), other equipment or any damage or liability I may ultimately be found responsible for, from the point of my entry into the ride, during the ride and during my return to the final destination. I further certify that I currently have a lawful licensed to operate a motorcycle and possess the competence to operate a motorcycle in a safe manner. I further certify that my operator’s license has all endorsements required to legally operate a motorcycle in the State of Virginia.

3. In consideration of my being permitted to participate in this event, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) Waive, Release and Discharge from any and all liability for my death, disability, personal injury, property damage, property theft or actions of any kind which may hereafter accrue to me during the event or during my traveling to and from this event, THE FOLLOWING ENTITIES OR PERSONS: The Cross Bearers Motorcycle Ministry, it’s officers, the Autism Society Central VA, it’s directors, employees, any ride organizers, sponsors, representatives, volunteers and (B) indemnify and Hold Harmless the entities or persons mentioned in this paragraph from any and all liabilities or claims made by other individuals or entities as a result of any of my actions during this event. Accordingly, I do hereby release and discharge the Cross Bearers Motorcycle Ministry, its officers, the Autism Society Central VA, it’s directors, employees, any ride organizers, sponsors, representatives and their officers, from all claims, demands, and causes of action of every kind whatsoever for any death, damages or injuries which may result from my participation in this event. This shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. I hereby consent to receive medical treatment, which may be deemed advisable in the event of injury, accident and or illnesses during the event. I agree to pay for any and all costs related to medical response, treatment and transport on my behalf.

4. I certify that I will wear all personal protective equipment while operating my motorcycle at this event that is or might be required by the state of Virginia while participating in the ride. Also agree that my motorcycle and all required personal protective equipment are in safe operational condition. I also agree to abide by the directions or rules given by the organizers of this event and I understand that my privilege to ride in the event may be removed without refund if I am in violation of the rules set forth or for acting or performing in an unsafe manner to include any manner disruptive to the operation of the event. I agree to pay for all expenses (including, but not limited to lodging, food, beverages, gasoline, oil, repairs and maintenance and any other costs or expense I may incur) intending that the Cross Bearers Motorcycle Ministry shall be totally free of such costs and expense.

5. As additional consideration for being allowed to participate in the event, I hereby assign to the Cross Bearers Motorcycle Ministry any claim I have or might have, in any way, shape, form or fashion arising out of its action, the actions of other riders or anyone that participates in or comes in contact with participants in the event. This assignment is intended by all parties to be a full and complete assignment of any claim I have against the Cross Bearers Motorcycle Ministry, the Autism Society Central VA, any officers, directors, employees, the ride organizers, sponsors, volunteers and their representatives or may have against entities and individuals listed in this paragraph whether directly or through third parties. The intent of the parties is that The Cross Bearers Motorcycle Ministry and the Autism Society Central VA, their officers, directors, employees, ride organizers, sponsors, volunteers or representatives shall be liability free with regard to anything in any way connected with the event.

I hereby certify that I have read this Waiver pertaining to the Release and Assignment of Claims in
its entirety. My engaging the “SUBMIT” button below indicates that I fully understand it and agree to its contents.

Please Pay the amount by clicking on the Donate Button and entering the amount owed. A print out will be compiled with this information before the actual ride. Thank You!

The Cross Bearers MM is a 501-C3 Organization. All Charitable Donations are Tax Deductable