AGREEMENT, WAIVER & RELEASE OF LIABILITY

EVERY APPLICANT MUST SIGN AN INDIVIDUAL WAIVER! This form may be photocopied, however, photocopies of signed waivers will not be accepted.

I, the undersigned, know Tour d' Omaha, a bicycle tour on public streets, is a potentially hazardous activity and I attend it out of my own free will and choice. In choosing to participate including any related events, I fully accept and assume all risks, whether before, during or after Tour d' Omaha and its related events. These include, without limitation, physical injury, mental injury, emotional distress, trauma, sickness, illness, death, contact with other participants, equipment failure, inadequate safety equipment, the effects of weather including extreme temperatures or conditions, traffic, contact with motor vehicles of all types and descriptions, collision with other riders or fixed objects, the conditions of the road, and participating in events along the route. All risks are known and appreciated by me. I waive any and all specific notice of the existence of the risks. I shall assume and pay my own medical and emergency expenses in the event of injury, illness, or other incapacity regardless of whether I authorized such expenses.

I understand this event is a bike ride and not a race. I realize that participation in this event requires prior physical conditioning and I represent that I am in sound medical condition capable of participating in the ride without risk to myself or others. I have no medical IMPEDIMENT, WHICH would endanger OTHERS OR MYSELF. I understand and agree that a situation may arise during Tour d' Omaha which may be beyond the control of the sponsors, promoters or organizers. I will be solely responsible for the condition and adequacy of my bicycle, safety gear, clothing and riding equipment and for the bicycle, safety gear, clothing and riding equipment used by minors for whom I am responsible. I will ride safely within the limits of my own abilities, my equipment and the riding conditions and in a manner so as not to endanger either OTHERS OR MYSELF.

Knowing these facts and in consideration of my entry acceptance, admission to and/or participation in Tour d' Omaha and its related events, I for myself and anyone acting on my behalf, release, waive, discharge, covenant not to sue and agree to hold Tour d' Omaha organizers, sponsors, officials, emergency and support personnel, volunteers and their representatives; and the officers, directors, employees, representatives, agents, and successors of all of the above, harmless from any and all claims, demands and actions of any and every kind I have, may have or may hereafter accrue against the released parties directly or indirectly arising out of or relating In any respect to my attending or participating in Tour d' Omaha and its related events. My waiver and release of all claims, demands, actions and liability shall include without limitation, any injury, damage or loss to my person or property which may be (a) caused by any act, or failure to act, by the above identified persons and entities or (b) sustained by me before, during or after Tour d' Omaha and its related events. I agree to abide by all event requirements, traffic rules and regulations in City of Omaha and the State of Nebraska.

I understand that my name, photograph, voice and/or likeness may be used in promotional materials of or by Tour d' Omaha. I consent to such uses and waive any rights of privacy or publicity I may have in connection with those uses. I further agree to indemnify and hold the parties released above harmless from any and all losses, damages, claims and expenses, including attorneys' fees, arising from or relating in any respect to my participation in Tour d' Omaha or its related events or my breach of this agreement.

If I am a minor, my parent or guardian also is signing on my behalf and we both agree to be bound by the terms of this agreement, waiver and release.

I HAVE READ THIS AGREEMENT, WAIVER AND RELEASE, AND AGREE TO AND ACCEPT ITS TERMS.

Printed Name: ______________________________________________

Signature: _________________________________________________Date: ________________

Signature of Parent: __________________________________________Date: ________________
(if under 18 years of age)