The terms below are important for you to read through.  They provide you all of the information you need to know about your registration, fundraising deadlines, and cancellation terms.  By registering online and/or signing this form, you agree to all terms outlined below:

FUNDRAISING AGREEMENT

In consideration for the acceptance of my registration in the 2017 Chainbreaker cycling event (the “2017 Chainbreaker”), I agree to collect the fundraising minimum applicable to my route: $2000 for the 180 mile two-day ride, $1500 for the 100 mile one-day ride, $1250 for the 50 mile one-day ride and $1000 for the 25 mile one-day ride.  Further, in the event that I fail to collect the required fundraising minimum by the fundraising deadline of October 13, 2017, I agree to be personally responsible to Chainbreaker for the difference between the amount I collected and the fundraising minimum.  I have provided Chainbreaker with a valid credit card number and associated information and agree to maintain such credit card active for the duration of this Agreement or notify Chainbreaker of any changes in my credit card information. I understand that if I have failed to meet the fundraising minimum by October 13, 2017, the difference between the amount I collected and the fundraising minimum will be charged to my credit card.  I hereby acknowledge and agree that Chainbreaker is authorized to charge my credit card in the event the fundraising minimum is not met by October 13, 2017.

REGISTRATION FEE

The registration fee for the 2017 Chainbreaker is $100.00 and must be paid via credit card prior to or concurrent with the submission of my registration form.  I understand my registration will not be approved without receipt of the registration fee.

THE REGISTRATION FEE IS NOT REFUNDABLE AND NOT TRANSFERABLE. THE FEE IS NOT FUNDRAISING AND THEREFORE WILL NOT APPLY TOWARDS MY FUNDRAISING MINIMUM.

PAYMENT ON DEMAND

I agree to pay, upon demand, costs of collection of all amounts due under this Fundraising Agreement and Liability Waiver, including, without limitation, all costs and expenses to enforce my obligations hereunder, including reasonable attorneys’ fees.

CANCELLATION POLICY

I acknowledge and agree that by registering for any 2017 Chainbreaker route, I am responsible for the fundraising minimum applicable to my route.  If for any reason I cancel my participation on or before 11:59 p.m. on Tuesday, July 11th, 2017, I will not be responsible for the fundraising minimum.  However, if I cancel my participation in the 2017 Chainbreaker after July 11, 2017 for any reason, including illness or injury rendering me unable to participate in the 2017 Chainbreaker, I remain personally responsible for the fundraising minimum.

COMPLETE RELEASE OF LIABILITY

I acknowledge that participating in a cycling event or other athletic event, including any pre-event training and related activities, is a potentially hazardous activity and that the risk of injury from participation in the 2017 Chainbreaker is significant, including the potential for permanent paralysis and death, and while particular rules, equipment and personal discipline may reduce this risk, the risk of serious injury does exist. 

I hereby agree not to participate in the 2017 Chainbreaker unless I am medically able and properly trained.  I agree to abide by any decision of a 2017 Chainbreaker official relative to my ability to safely complete the event.  I am voluntarily entering the 2017 Chainbreaker and assume all risks, both known and unknown, associated with participation, even if arising from the negligence of the Releasees (as defined below) or others, and whether or not covered by my personal health or other type of insurance.   I knowingly and freely assume full responsibility for my participation in the 2017 Chainbreaker.

I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately.

I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS Chainbreaker, its officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises, property and/or equipment used to conduct the event (“Releasees”), WITH RESPECT TO ANY AND ALL PRESENT AND FUTURE CLAIMS AND LIABILITIES OF ANY KIND, KNOWN OR UNKOWN, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

I HAVE READ THIS COMPLETE RELEASE OF LIABILITY, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

GRANT OF PERMISSION

I grant permission to Chainbreaker to use my name and/or likeness in photographs, video, and/or written materials directly connected to promoting the 2017 Chainbreaker or any other Chainbreaker events.

ACKNOWLEDGMENT

I HAVE READ THIS FUNDRAISING AGREEMENT AND LIABILITY WAIVER IN ITS ENTIRETY, FULLY UNDERSTAND ITS TERMS AND CONDITIONS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

Signature:__________________________________ Date:___________

Full Name (Print): _______________________________________________