CWA Fernie Society-Waiver 

I the under signed, am the passenger named herein taking part in the CWA Fernie Society Cycling Without Age program as a passenger. 

  • I understand and agree that there are inherent risks associated with participation in this activity, that my participation is voluntary and that I am physically fit enough to participate in the activity. 
  • I accept all responsibility for my participation including the possibility of personal injury, death, property damage of any kind notwithstanding that the injury, loss may have been contributed to or occasioned by negligence of the CWA Fernie Society and its officers, directors, employees, members, agents assigns, legal representatives and successors. 
  • I do hereby indemnify and hold harmless the CWA Fernie Society, its officers, directors, employees, members, agents, assigns, legal representatives and successors and any and all business associates and partners involved in the above noted activity and each of them, their owners, officers and employees hereby waiving all claims for damage now or in the future arising from any loss, accident, injury or death which may be caused by or arise from participation of the individual named herein during this event; and agree to assume all risks for the activity noted above that the individual named herein has agreed to participate in.

My signature acknowledges that I am over the age of 18 and had sufficient time to read and understand this waiver. I have had the opportunity to seek my own legal advice and that I understand and agree to the conditions stated in this document and that they are binding on my heirs, next of kin, executors, administrators and successors. 

Signed this_______________ day of ___________________________ 2021

Participant Name: ________________________________________________________


Phone Number:___________________________________________________________


Address:___________________________________________________________________


Participant Signature:____________________________________________________


Witness Name:___________________________________________________________ 

Witness Signature________________________________________________________