PARTICIPANT AGREEMENT, RELEASE AND ASSUMPTION OF RISK
In consideration of the services of Harris Technology LLC d/b/a Zip Rides their agents, owners, officers, volunteers, employees, and all other persons or entities acting in any capacity on their behalf (hereinafter collectively referred to as "ZIP"), I hereby agree to release, indemnify, and discharge ZIP, on behalf of myself, my spouse, my children, my parents, my heirs, assigns, personal representative and estate as follows:
1. I acknowledge that my participation in moped and scooter riding activities entails known and unanticipated risks that could result in physical or emotional injury, paralysis, death, or damage to myself, to property, or to third parties. I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity.
THE RISKS INCLUDE, AMONG OTHER THINGS : slipping and falling; accidents involving vehicles; collision with fixed or movable objects; injuries or accidents involving contact with the vehicle; falls from the vehicle; accidents can occur getting on or off; I can be jolted, jarred and bounced during ride; major injuries are a risk as are bruises and sprains; musculoskeletal injuries including head, neck, and back injuries; further, passengers can be thrown off the vehicles which can result in any of the above events occurring; collisions, and flipping over; the machine itself may fail; the negligence of other participants, spectators, or persons who may be present; damage to equipment or personal injury; exposure to the elements of the outdoors and natural surroundings which could cause hypothermia, hyperthermia (heat related illnesses), heat exhaustion, sunburn, dehydration; transmissible pathogens or diseases; condition of roads, terrain, or highways and accidents connected with their use; accidentsor illness can occur in remote places without medical facilities and emergency treatment or other services rendered; improper lifting or carrying; my own physical condition, and the physical exertion associated with this activity.
Furthermore, ZIP personnel have difficult jobs to perform. They seek safety, but they are not infallible. They might be unaware of a participant's fitness or abilities. They might misjudge the weather or other environmental conditions. They may give incomplete warnings or instructions, and the equipment being used might malfunction.
2. I expressly agree and promise to accept and assume all of the risks existing in this activity. My participation in this activity is purely voluntary, and I elect to participate in spite of the risks. I agree to wear a properly fitted and secured DOT or SNELL certified helmet while participating in this activity.
3. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless ZIP from any and all claims, demands, or causes of action, which are in any way connected with my participation in this activity or my use of ZIP’s equipment or facilities, INCLUDING ANY SUCH CLAIMS WHICH ALLEGE NEGLIGENT ACTS OR DISEASES OR OMMISSIONS OF ZIP.
4. Should ZIP or anyone acting on their behalf, be required to incur attorney's fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs.
5. I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating, or else I agree to bear the costs of such injury or damage myself. I further certify that I am willing to assume the risk of any medical or physical condition I may have.
6. In the event that I file a lawsuit against ZIP, I agree to do so solely in the state of Kentucky and I further agree that the substantive law of that state shall apply in that action without regard to the conflict of law rules of that state. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining document shall remain in full force and effect.
BY SIGNING THIS DOCUMENT, I ACKNOWLEDGE THAT IF ANYONE IS HURT OR PROPERTY IS DAMAGED DURING MY PARTICIPATION IN THIS ACTIVITY. I MAY BE FOUND BY A COURT OF LAW TO HAVE WAIVED MY RIGHT TO MAINTAIN A LAWSUIT AGAINST ZIP ON THE BASIS OF ANY CLAIM FROM WHICH I HAVE RELEASED THEM HEREIN. I ALSO AGREE THAT THIS DOCUMENT IS VALID FOR SUBSEQUENT VISITS AND PARTICAPATION AT ZIP. I HAVE HAD SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE READ AND UNDERSTOOD IT , AND I AGREE TO BE BOUND BY ITS TERMS.
Print Name______________________________________________________________ Phone Number________________________________________
Signature of Participant_________________________________________________________________________Date___________________________
PARENT'S OR GUARDIAN'S ADDITIONAL INDEMNIFICATION (Must be completed for participants under the age of 18)
In consideration of the following minor(s): (printname(s))_________________________________________________________________________
being permitted by ZIP to participate in its activities and to use its equipment and facilities, I further agree to indemnify and hold harmless ZIP from any and all claims which are brought by, or on behalf of minor(s), and which are in any way connected with such use or participation by minor(s). Minor(s) DOB(s)_______________________________________________________________________________________
Parent or Guardian: Print Name: __________________________________________________Date__________________________________________