Lee Cougan Demo Waiver Form

Please keep in mind that this is a test ride. There are others wanting to test ride this bicycle as well. YOU are responsible for damage to the bicycle.

I acknowledge that by signing this document I am releasing Five Star Bicycles from liability. This application is a contract with legal consequences. I have been advised to read it carefully before signing. In consideration of the acceptance of my application for entry into this club, I hereby freely agree to and make the following agreements:

• I acknowledge that cycling is an inherently dangerous sport and fully realize the dangers of participating in a bicycle race or ride and fully accept the risks associated with such participation, including by way of example and not limited to, the following: the dangers of collision with pedestrians, vehicles and other racers, of conditions and of the possibility of serious physical and mental trauma or injury associated with athletic cycling.

• I acknowledge, agree and represent that I understand the nature of bicycling and E-Biking, including the activity, and that I am qualified, in good health, and in proper physical condition to participate in such activity. I further acknowledge that the activity will be conducted over public road and facilities open to the public during the activity and upon which the hazards of traveling are to be expected. I further agree and warrant that if at any time I believe conditions to be unsafe, I will immediately discontinue further participation in the activity.

• For myself, my heirs, executors, administrators, legal representative and successors in interest (collectively “Successors”) I hereby waive, release, discharge, hold harmless, promise not to sue and indemnify the sponsors of each event, Five Star Bicycles, the organizer and any promoting organization, property owners, law enforcement agencies, all public entities, special districts, properties and their respective agents, officials, employees and volunteers through or by which the events will be held (Collectively, the “released parties”) from any and all claims including claims that may hereafter accrue to me and from any and all damages that may be sustained by me directly or indirectly in connection with, or arising out of my participation in or association with the event or in travel to or return from the event.

• I agree it is my sole responsibility to be familiar with the race or ride course, area rules and any special regulations for the event. I understand and agree that situations may arise during the race or ride that may be beyond the immediate control of the race officials or ride organizers, and I must continually ride so as to endanger neither myself nor others. I accept responsibility for the condition and adequacy of my competition and ride equipment. I will ride and compete wearing a helmet which satisfies the requirements of at least one of the following standards: ANSI, SNELL, CPSC — and that can protect against serious head injury, and assume all responsibility and liability for the selection of such a helmet. I have no physical or medical condition that, to my knowledge, would endanger myself or others if I participate in this event, or that would interfere with my ability to participate in this event.

• I agree for myself and my successors that the above representations are contractually binding and are not mere recitals, and that should I or my successors assert a claim in contravention of this agreement, the asserting party shall be liable for the expenses (including legal fees) incurred by the other party or parties in defending, unless the other parties are finally adjudged liable on such a claim for willful and wanton negligence. This agreement may not be modified orally and with any provision herein or as consent to any subsequent waiver or modification.