Join Online

Thanks for joining the DGBC online. Please complete the membership application and hit the “Send” button. You’ll then be directed to our Paypal page to pay your dues.

NEW:  Our Release of Liability Waiver form is now built into the membership application.  If you’ve already joined and need to sign a waiver, you can do so here.

Membership Type:  

INDIVIDUAL MEMBERSHIP INFORMATION

Your Full Name:

Your Email:
Address:
City:
Zip:
Cell Phone: Home Phone:

ADDITIONAL INFORMATION

What sort of riding do you enjoy? Check all that apply.
What pace do you usually ride (road riding)?
Would you be interested in helping in any of the following?

FAMILY MEMBERSHIP INFORMATION

Tell us the names of your other family members if you chose a family membership:

Name: Age:
Name: Age:
Name: Age:
Name: Age:

2014 RELEASE OF LIABILITY

Please read the release of liability waiver form and indicate your acceptance below.

In consideration of being allowed to participate in any way in the Downers Grove Bicycle Club (hereafter: 'Club') program, its related events and activities, I, the undersigned, acknowledge, appreciate, and agree that:

1. The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular skills, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and,

2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,

3. 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 hazard to the attention of the Club immediately; and,

4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS the Downers Grove Bicycle Club, its officers, officials, agents and/or employees, other event participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners, lessors and lessees of premises used for the activity ("Releasees"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property associated with my presence or participation, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

Adult Cyclist Name and Signature

Name: Date:

Checking this box serves as your legal signature and agreement to the terms of this waiver.

 I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY THREAT, DURESS, PROMISE OR INDUCEMENT.

Second Adult Cyclist Name and Signature

Name: Date:

Checking this box serves as your legal signature and agreement to the terms of this waiver.

 I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY THREAT, DURESS, PROMISE OR INDUCEMENT.

FOR PARENTS/GUARDIANS OF PARTICIPANTS OF MINORITY AGE.

 This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releasees, and, for myself, my child and our heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child's involvement or participation in these programs as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law.

Date:

When you click "send" your information will be submitted and you will be redirected to a payment page where you can pay your club dues.


One Response

  1. Downers Grove Bicycle Club : A WordPress Site - Beezodog's Place

    [...] Join Online [...]


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