BBC Membership Form

Bloomington Bicycle Club Membership Form

Type in the requested information and print the form using your browser's PRINT function. It should print on one page. But we recommend using print preview and/or the print option to fit on one page, if available. Mail the completed form, along with your check for dues, to: Bloomington Bicycle Club, P.O. Box 463, Bloomington, IN 47402-0463

New member Renewal

Name(s)

Address

City State Zip

Phone
E-mail

Annual dues $15.00 individual $20.00 family Checks payable to Bloomington Bicycle Club

I might like to volunteer for the following: touring committee social committee membership and mailings RAIN club newsletter grants committee safety and education committee advocacy committee
Add our name(s) to the roster of tandem riders Add our name(s) to the roster of mountain bikers

Check any affiliations: Indiana Bicycle Coalition League of American Bicyclists International Mountain Biking Association National Off-Road Bicycling Association Adventure Cycling Association United States Cycling Federation Randonneurs USA Other (specify)

PARTICIPANT RELEASE OF LIABILITY OF BLOOMINGTON BICYCLE CLUB, INC.
The undersigned understand the inherent risk in participating in bicycling activities. As a condition of my membership and participation in events sponsored by the Bloomington Bicycle Club, Inc., I agree for myself, for family members, heirs, executors, and administrators that I will under no circumstance pursue, prosecute, or present any claims for personal injury, property damage, contractual breach or wrongful death against the Bloomington Bicycle Club, Inc., its officers, directors, agents, or employees regardless of whether the cause of action shall arise by the negligence of Bloomington Bicycle Club, Inc., and its representatives or otherwise. IT IS THE INTENTION OF THE UNDERSIGNED TO EXEMPT AND RELEASE BLOOMINGTON BICYCLE CLUB, INC., AND ITS REPRESENTATIVES FROM ANY AND ALL LIABILITY FOR ALL CAUSES OF ACTION FOR PERSONAL INJURY, PROPERTY DAMAGE, CONTRACTUAL BREACH OR WRONGFUL DEATH CAUSED BY NEGLIGENCE. The undersigned voluntarily assumes, accepts and incurs all risks associated with or incidental to the activity of bicycling, or related activities, whether foreseen or unforseen, for injury, damage or death, which may occur in connection with the sport or related activity. The Participant's signature acknowledges that he or she has read, fully understands, and knowingly and voluntarily agrees to be bound by the terms of this Release and Limitation of Liability. ALL PARTICIPANTS SIGN AND DATE THIS FORM ON THE LINE BELOW. (Parents or guardians sign on behalf of minors.) Date

PARTICIPANT RELEASE OF LIABILITY OF BLOOMINGTON BICYCLE CLUB, INC.

The undersigned understand the inherent risk in participating in bicycling activities. As a condition of my membership and participation in events sponsored by the Bloomington Bicycle Club, Inc., I agree for myself, for family members, heirs, executors, and administrators that I will under no circumstance pursue, prosecute, or present any claims for personal injury, property damage, contractual breach or wrongful death against the Bloomington Bicycle Club, Inc., its officers, directors, agents, or employees regardless of whether the cause of action shall arise by the negligence of Bloomington Bicycle Club, Inc., and its representatives or otherwise. IT IS THE INTENTION OF THE UNDERSIGNED TO EXEMPT AND RELEASE BLOOMINGTON BICYCLE CLUB, INC., AND ITS REPRESENTATIVES FROM ANY AND ALL LIABILITY FOR ALL CAUSES OF ACTION FOR PERSONAL INJURY, PROPERTY DAMAGE, CONTRACTUAL BREACH OR WRONGFUL DEATH CAUSED BY NEGLIGENCE. The undersigned voluntarily assumes, accepts and incurs all risks associated with or incidental to the activity of bicycling, or related activities, whether foreseen or unforseen, for injury, damage or death, which may occur in connection with the sport or related activity. The Participant's signature acknowledges that he or she has read, fully understands, and knowingly and voluntarily agrees to be bound by the terms of this Release and Limitation of Liability. ALL PARTICIPANTS SIGN AND DATE THIS FORM ON THE LINE BELOW. (Parents or guardians sign on behalf of minors.)

Date