Mohican 100 Mountain Bike Race – Waiver
Posted on: 27 Oct 2012

 

 

Mohican MTB 100 State Park and Forest WAIVER AND LIABILITY
RELEASE

Please
Bring a signed copy to race registration and packet pickup

 

(Please print all information
except signature to allow for more accurate records)
NAME:________________________________________________________
ADDRESS:_____________________________________________________
CITY:_________________________________________________________ STATE:___
ZIP__________ DATE_________ __MALE __FEMALE AGE____ E-MAIL
ADDRESS_________________________________________

WAIVER

I, intending to be legally bound,
hereby, for myself, my heirs, executors and administrators, voluntarily assume
all risks of accident or injury and release and forever discharge the State
of Ohio, Ohio Department of Natural Resources, and its employees, officers
and agents, from any and all liability for personal injury or property damage
of any kind sustained at Mohican State Park and/or Mohican Memorial State
Forest during the Mohican MTB 100 event held on June 1, 2019
whether such personal injury or property damage is caused by negligence of
the State of Ohio, Ohio Department of Natural Resources, or its employees,
officers, or agents or otherwise. I further covenant and agree to indemnify
and hold harmless the State of Ohio, and the Ohio Department of Natural
Resources, its employees, officers, and agents, from all loss and expense,
including but not limited to, damages, legal expenses, and cost of defense,
in any manner arising from my use of the State Park and/or State Forest.

______________________________________

 

_____________

Participant (signature)

 

Date

______________________________________

 

_____________

Participant (name printed
legibly)

 

Date

______________________________________

 

_____________

Parent or legal guardian
(signature) if participant in under 18 years of age

 

Date

______________________________________

 

_____________

Parent or legal guardian (name
printed)

 

Date