Skip to form

Village of Arlington Heights

communications@vah.com

33 S. Arlington Heights Road , Arlington Heights , IL, 60005, US

847-368-5000

Child/Minor Community Bike Ride Registration and Waiver

 

MINORS - OPEN COURSE - BIKE ARLINGTON HEIGHTS PERMISSION FORM RELEASE AND INDEMNIFICATION

(FOR MINORS – MUST BE COMPLETED BY A PARENT)

Please fill out the form below for a minor under the age of 18 to participate in the Bike Arlington Heights event held on Saturday, May 20, 2023. Thank you for your participation!

WHEREAS,    "Minor”, as of the date of the Bike Arlington Heights event, will be under the age of 18 years old and would like to participate in Bike Arlington Heights, a recreational bike ride (“Event”)

WHEREAS, the Village of Arlington Heights, a municipal corporation, ("Village") is willing to grant permission to participate in the event,

NOW, THEREFORE, in consideration for permission to participate in this event and for other good and valuable consideration herein acknowledged, the undersigned agrees as follows:

I give my minor permission to participate in this event;

I understand that no roads are closed.  All riders must obey all traffic laws and will be crossing busy streets that are open to vehicular traffic;

I understand that there are inherent risks involved in this event;

I understand and agree that if my child suffers any injuries, payment for medical care will be my responsibility;

 I understand and agree that despite careful and proper preparation, instruction, medical advice, conditioning and equipment, there is still a risk of serious injury when participating in any recreational activity/program. Understandably, not all hazards and dangers can be foreseen. I understand that certain risks, dangers and injuries due to inclement weather, slip and falls, poor skill level or conditioning, carelessness, horseplay, unsportsmanlike conduct, premises defects, inadequate or defective equipment, inadequate supervision, instruction or officiating, and all other risks inherent to indoor and outdoor recreational activities/programs exist. I recognize that it is impossible for the Village to guarantee absolute safety;

I hereby release and hold harmless the Village of Arlington Heights and its officers, agents, and employees from any and all liability, losses or damages, including attorneys' fees and costs of defense the Village may suffer as a result of claims, demands, suits, actions or proceedings of any kind or nature, in any way resulting from my child’s participation in this event.   I will, at my own expense, appear, defend and pay all fees of attorneys and all costs and other expenses arising therefrom or incurred in connection therewith; and, if any judgments shall be rendered against the Village in any such action, I will, at my own expense, satisfy and discharge same. By signing below, you certify that you have read and agree to the terms presented herein:

 

I certify I agree to the terms of the Arlington Heights Release & Indemnification Form for the Bike Arlington Heights Event

Parent/Guardian Full Name

Minor's Full Name

Please check which distance the minor listed above plans to ride

Parent/Guardian Signature

Choose how to sign