Rotary - Gold Country Challenge

Volunteer Sign Up Form

Please complete all fields.  Fields marked with an Asterisk * are required fields.

Click on the Submit button at the bottom of the form to complete the process.

Thank you for volunteering.  "Service Above Self"

*
*
*
*
*
*
*
*
Enter name of your Rotory Club volunteer group
Enter name of Other Volunteer Group


 
 
 
 

WAIVER AND RELEASE OF LIABILITY

I understand that I am applying to volunteer in an open roadway bicycle event on state and county road and highways or to assist as a volunteer in this event.  I may choose to work any or all loops or parts of the ride so long as I complete them as directed and know that all risks, hazards, and difficulties foreseen or unforeseen on the event day are assumed by me.  I make this waiver and release of liability on behalf of myself, my executors, administrators, heirs, next of kin, successors, and assigns. As consideration for participation in this event, I waive, release, discharge and hold harmless the volunteers, sponsors of the event, the Rotary Club of Grass Valley  and its members (hereafter referred to as “Sponsors,”) 17th District Agricultural Association (Nevada County Fair Grounds), Nevada County, Grass Valley, Nevada City, the State of California (hereafter, all four referred to as “Public Agencies”) and all of the Public Agencies’ subdivisions, agents, and employees and any law enforcement officers, agents, and employees from all claims, demands, and causes of action resulting from any death, personal injury, property damage, property theft, loss or injuries which may result from my participation in the Gold Country Challenge  I further agree to indemnify and hold harmless the Sponsors and Public Agencies from any liabilities and claims made by other individuals or entities as a result of my participation in this event, my carelessness or negligence while participating in the event or arising from an inaccuracy in any of the representations made by me in this Waiver and Release of Liability.

I recognize that this event is strenuous and a potentially dangerous activity and acknowledge that I am experienced and have conditioned myself sufficiently to participate.  Participation in this event carries with it certain risks including but not limited to, those caused by terrain, road conditions, facilities, temperature, weather, condition of other participants, equipment, vehicular traffic, lack of hydration, and the acts or omissions of other people including but not limited to, participants, volunteers, spectators, event officials, event monitors and Sponsors or Public Agencies.  With knowledge of the risk involved, I hereby agree to accept any and all risks or injury or death associated with my participation in this event. 

I will obey all pertinent laws related to cycling on public roads.  I certify that I will be wearing a helmet at all times while riding a bicycle.  I consent to receive medical treatment which may be deemed advisable in the event of injury, accident or illness during this event.

I further grant unqualified permission to use my photograph/image/likeness, name or comments relative to this event for publicity or promotion of the ride without any financial obligation to me or liability to the sponsors.

 
*
 
* Enter the Security code shown above CAPTCHA