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PARTICIPANT AGREEMENT, RELEASE AND ASSUMPTION OF RISK.
You must be 16 years of age to ride scooters in the state of Kentucky.
I acknowledge I am over the age of 16 and agree to the following terms:
It is a city ordinance in Ashland KY not to ride scooters on the sidewalks, I agree to abide by this ordinance.
To prevent theift and damage to the scooters I rent. I agree to be responible and liable for ending my scooter ride in the designated Ziprides parking areas when I am finished with my ride. I also agree to be responisble and liable to pay for the cost of the ride and any damages incurred to the scooter caused by misuse or neglect which is
the result of me not ending my ride.
In consideration of the services of Harris Technology LLC DBA: 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 Segway, 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; condition of roads, terrain, or highways and accidents connected with their use; accidents or 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 omissions 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 participation 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. Each participant must sign their own liability release form that is of the age of 18 or older. Anyone under the age of 18 must have the release signed by their parent or legal guardian. Print Name___________________________________ Phone Number__________________________Address_________________________________ City_____________________________________ State____________________________________ Zip______________________________________ Email___________________________________Signature of Participant______________________________ Date___________ PROTECTIVE RIDING HEADGEAR REFUSAL AGREEMENTI, the undersigned, have been fully warned and advised by Harris Technology LLC DBA ZIP RIDES (hereinaftercollectively referred to as “ZIP”), that I should wear a properly fitted and secured helmet while participating inZIP (whether on the premises or off of the ZIP’s premises) in order to potentially reduce the severity of an injuryand/or to possibly prevent my death from occurring as the result of a fall or any other occurrence associated withthis activity. I understand that by not wearing a helmet, I will be going against manufacturers’ requirements andputting myself at an increased risk for injuries, and against the advice of ZIP and numerous court cases I am refusingthis critical safety precaution. I also understand that minors are not allowed to refuse protective headgear and Icannot sign on their behalf to waive the requirement.I, the undersigned, have read the foregoing statement carefully before signing and do understand itswarning.__________________________________________________________________________________________Name of Rider__________________________________________________________________________________________Signature of Rider Date
1. I acknowledge that my participation in Segway, 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; condition of roads, terrain, or highways and accidents connected with their use; accidents or 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 omissions 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 participation 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. Each participant must sign their own liability release form that is of the age of 18 or older. Anyone under the age of 18 must have the release signed by their parent or legal guardian. Print Name___________________________________ Phone Number__________________________Address_________________________________ City_____________________________________ State____________________________________ Zip______________________________________ Email___________________________________Signature of Participant______________________________ Date___________ PROTECTIVE RIDING HEADGEAR REFUSAL AGREEMENTI, the undersigned, have been fully warned and advised by Harris Technology LLC DBA ZIP RIDES (hereinaftercollectively referred to as “ZIP”), that I should wear a properly fitted and secured helmet while participating inZIP (whether on the premises or off of the ZIP’s premises) in order to potentially reduce the severity of an injuryand/or to possibly prevent my death from occurring as the result of a fall or any other occurrence associated withthis activity. I understand that by not wearing a helmet, I will be going against manufacturers’ requirements andputting myself at an increased risk for injuries, and against the advice of ZIP and numerous court cases I am refusingthis critical safety precaution. I also understand that minors are not allowed to refuse protective headgear and Icannot sign on their behalf to waive the requirement.I, the undersigned, have read the foregoing statement carefully before signing and do understand itswarning.__________________________________________________________________________________________Name of Rider__________________________________________________________________________________________Signature of Rider Date