ELMHURST BICYCLE CLUB MEMBERSHIP FORM
Membership Type:
Individual ($20)
Family ($25)
New Member or Renewal:
New Member
Renewal
EBC's membership year runs from January 1 to December 31.
Name
(If family membership, list names of all members.)
Address
City
State
Zip Code
Phone: Home
Work
Cell
Email
NOTE: Indicate with ** next to any information you
do not want
to appear in the club directory.
New item:
I give permission to have the above information, except the items marked with **, posted in a password-protected online directory.
If you do not want to be included in an online directory, check here.
The Following Is A Release And Waives Your Rights In the Event of Injury and/or Death. In consideration of being permitted to be a member of Elmhurst Bicycle Club and to participate In club rides and/or events, including transportation to and from same, I do hereby for myself, my heirs, executors and administrator release, waive and forever discharge Elmhurst Bicycle Club, its officers and members from any and all claims, demands, actions or liabilities on account of any injury to me which may occur from any cause whatsoever, including negligence or other fault on the part of anyone released hereunder, during my participation in or transportation to or from said rides and/or events. I ACKNOWLEDGE I AM AWARE OF THE RISKS AND HAZARDS INHERENT UPON ENGAGING IN SAID CLUB ACTIVITIES, AND I DO SO ENTIRELY UPON MY OWN INITIATIVE, RISK AND RESPONSIBILITY. I FURTHER UNDERSTAND THE CLUB DEPENDS ON ITS MEMBERS TO PROVIDE AND LEAD CLUB ACTIVITIES AND THAT THOSE MEMBERS RELY ON THE PROTECTION AFFORDED HEREUNDER. I hereby further agree to operate my bicycle in a manner that is safe to me and those around me, to observe all applicable safety regulations and to conduct myself in a manner that will be complimentary to the sport of bicycling. It is my intent that this release and waiver apply at all times, notwithstanding that my membership in the Elmhurst Bicycle Club may have expired, elapsed, been renewed or reinstated after a period of non-membership. I FURTHER ACKNOWLEDGE THAT I HAVE READ THE FOREGOING RELEASE AND WAIVER AND UNDERSTAND IT, INCLUDING THAT IT IS INTENDED TO COVER OCCURRENCES WHICH MAY NOT YET HAVE OCCURRED AND WHICH ARE UNKNOWN TO ME, AND NOTWITHSTANDING THE FOREGOING, I SIGN IT VOLUNTARILY WITH THE FULL INTENT THAT IT BE FOREVER ENFORCEABLE.
Click the button to accept the above release and proceed: