PROGRAM REGISTRATION FORM

Participants (and their parents/guardians if a minor) are required to adhere to all of the following rules for Pedal Forward programs and events, including Earn-a-Bike, Free Bike Repair, or organized community service. Failure to comply with these rules will result in termination of your participation and right to an earned bicycle.

Conduct: All participants are required to follow directions, to use positive words, exhibit positive actions, and to keep a positive attitude.

Questionable Items: Our staff and volunteers retain the right to confiscate any potentially dangerous or illegal items that may be in your possession. Disciplinary and/or legal action will be taken where necessary.

Interaction: All participants are to interact with others in a friendly and respectful manner, following all rules.

Assumption of Risk: Bicycle Riding: Participants understand that bicycling activities involve inherent risks, including the risk of serious injury or death. By signing this document, the participant (and parent/guardian if <18) assume those risks and any other risk incidental to Pedal Forward programs. All Pedal Forward bicycles that are not purchased will be earned via the Earn-a-Bike Program.
 
Assumption of Risk - Community Service: Earn-a-Bike participants may take part in community service, either through partner organizations, organized opportunities, or verifiable projects in the neighborhood. If picking up trash on streets, all participants are instructed and agree NOT to pick up dangerous or potentially dangerous items such as (but not limited to) broken glass, needles, nails, or anything else that could cut or injure them. 

Release of Responsibility: In consideration of the opportunity to participate in this program and its activities, the participant (and parent/guardian) will not hold Pedal Forward, its leadership team, volunteers, employees, or other involved organizations responsible or legally liable for any injuries to the participant or property, or the results thereof, incurred and suffered as a result of the participant’s participation in any of the activities or programs.

Willingness to Follow Instructions: All participants agree to use the equipment and facilities as instructed by Pedal Forward’s leadership and volunteer team. The participant understands that any failure to do so on their part may prevent their participation in these activities.

Fitness to Participate: The participant certifies that s/he has no physical or cognitive condition that would prohibit his/her participation in these activities. If s/he is now or has been in the past under treatment for any physical conditions that may limit participation, s/he will discuss it with the program supervisor and yield to his/her judgment as to whether s/he should participate. The participant understands that participation in these activities is entirely voluntary and that s/he may excuse him/herself from participation if so desired.

Permission to Treat: The participant (and parent/guardian if a minor) give permission to Pedal Forward volunteers and staff to administer routine non-emergency medical care for the participant. The participant agrees to disclose to Pedal Forward and its volunteers and leadership team any medical or other conditions that would prohibit the administration of such routine non-emergency medical care.

Loss Prevention: The participant’s belongings are his/her responsibility to keep track of and not lose. Pedal Forward is NOT responsible or liable for anything lost or stolen. Unauthorized items will be confiscated, if a minor, and returned to participant’s parents.

PHOTO & MEDIA RELEASE

I understand that photos and videos may be taken during Pedal Forward activities, and I authorize Pedal Forward to use such media on or in its website, in newsletters, social media, or other forms.

I have read the aforementioned rules and policies and have full understanding of the consequences for not following the rules. I understand that participating in Earn-a-Bike or any other Pedal Forward programs is a privilege that can be revoked at any time and that the rules and regulations may be changed at the discretion of Pedal Forward’s leadership team.

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