Pedal for a Purpose 2026 – Participant Waiver

PEDAL FOR A PURPOSE 2026 FUNDRAISER

ASSUMPTION OF RISK, RELEASE AND WAIVER OF LIABILITY

SAGA Empowerment Services Coalition (SAGAesc)

Participant Name *Enter your full name

Participant Email Address *Enter your email address

Participation TypeCyclistWalker

I confirm that I am 18 years of age or older. *I confirm that I am 18 years of age or older.

Are you signing this waiver on behalf of any participant(s) under the age of 18? *YesNo

Minor Participant #1 – Full Name *Minor Participant #1 – Full Name

Minor Participant #1 – AgeMinor Participant #1 – Age

Minor Participant #1 – ParticipationRiderWalker

Minor Participant #2 – Full Name *Minor Participant #2 – Full Name

Minor Participant #2 – AgeMinor Participant #2 – Age

Minor Participant #2 – ParticipationRiderWalker

Minor Participant #3 – Full Name *Minor Participant #3 – Full Name

Minor Participant #3 – AgeMinor Participant #3 – Age

Minor Participant #3 – ParticipationRiderWalker

Additional Minor Participant(s) – Name, Age & ParticipationIf you are signing for more than three minor children, please list each additional child’s full name, age, and indicate whether they are a Rider or Walker.

PARENT/GUARDIAN AUTHORIZATION

By signing below, I certify that I am the parent or legal guardian of the minor participant(s) listed above, or that I am legally authorized to sign on their behalf. I acknowledge that I have read and understand this waiver and voluntarily agree to its terms on behalf of each minor participant listed above. If I am also participating in the event, my participation is subject to the acknowledgments and terms of this waiver applicable to me.

Parent/Legal Guardian Name *

Parent/Guardian Electronic Signature *Type your FULL LEGAL NAME as your electronic signature

Parent/Guardian Date *

1. Assumption of Risk

In consideration of being permitted to participate in the Pedal for a Purpose 2026 Fundraiser (the “Event”), whether as a cyclist or walker, organized by SAGA Empowerment Services Coalition (“SAGAesc”), I understand that participation involves inherent risks.

These risks may include serious bodily injury, permanent disability or death; collisions or contact with vehicles, bicycles, pedestrians, other participants or objects; falls, slips, trips, uneven pavement and road or trail hazards; changing weather conditions; fatigue, dehydration or overexertion; bicycle or equipment malfunction; and other foreseeable or unforeseeable risks associated with an outdoor cycling or walking event.

I knowingly and voluntarily assume the risks associated with my participation in the Event, whether known or unknown.

Participant Initials – Assumption of Risk *Enter your initials

2. Release and Waiver of Liability

To the fullest extent permitted by law, I, on behalf of myself and my heirs, representatives, and estate, hereby release, waive, discharge, and covenant not to sue SAGA Empowerment Services Coalition (SAGAesc), its officers, directors, employees, volunteers, sponsors, agents, affiliates, and event partners for claims, demands, losses, damages, or liabilities arising out of or related to my participation in the Event, except to the extent such release is prohibited by applicable law.

I understand that by signing this waiver, I am giving up certain legal rights.

Participant Initials – Release and Waiver of Liability *Enter your initials

3. Medical Authorization

I certify that I am physically able to participate in the cycling or walking activities I have chosen for this Event.

If I become injured or ill during the Event, I authorize SAGAesc, its event personnel, volunteers, or emergency responders to obtain or arrange reasonable emergency medical assistance on my behalf when necessary.

I understand that I am responsible for any medical expenses incurred as a result of my participation, to the extent permitted by law.

Emergency Contact Name *Enter emergency contact’s full name

Emergency Contact Phone *Emergency Contact Phone

4. Equipment & Safety Requirements

For the safety of all participants, I agree to:

• Wear a properly fitted helmet at all times while cycling.
• Follow all applicable traffic laws, trail rules, posted signs, and Event safety instructions.
• Follow reasonable directions provided by Event staff and volunteers.
• Cycle or walk responsibly and remain alert to cyclists, walkers, vehicles, and my surroundings.
• Not wear headphones or earbuds while cycling or walking during the Event, so I can remain alert to traffic, other participants, warnings, and safety instructions.
• If cycling, use a bicycle and equipment that are in safe operating condition.
• Notify Event personnel of any serious accident, injury, or unsafe condition when reasonably possible.

I understand that failure to follow these safety requirements may result in removal from the Event without a refund.

Safety Acknowledgment *I understand and agree to comply with the Event safety requirements.

5. Photo & Media Release

I grant SAGA Empowerment Services Coalition (SAGAesc) permission to photograph, video record, or otherwise capture my image or likeness during the Pedal for a Purpose 2026 Fundraiser.

I authorize SAGAesc to use these photographs, videos, or recordings for its charitable, educational, promotional, fundraising, website, social media, and other nonprofit-related purposes without compensation to me.

Media Release Acknowledgment *I agree to the Photo & Media Release above.

6. Minor Participants

If the participant is under 18 years of age, a parent or legal guardian must consent to the minor’s participation in the Pedal for a Purpose 2026 Fundraiser.

As the parent or legal guardian, I certify that I am authorized to provide consent for the minor participant. I consent to the minor’s participation in the Event and acknowledge the risks associated with the minor’s participation.

7. Participant Acknowledgment

By submitting this electronic waiver, I acknowledge that I have read this Assumption of Risk, Release and Waiver of Liability in its entirety and understand its terms.

I understand that participation in the Pedal for a Purpose 2026 Fundraiser involves risks and that this document contains a release and waiver of certain legal rights.

I acknowledge that I am agreeing to these terms knowingly and voluntarily.

Waiver Acknowledgment *I have read, understand, and agree to the terms of this waiver.

Participant Initials – Final Acknowledgment *Enter your initials

Participant Electronic Signature *Type your FULL LEGAL NAME as your electronic signature

Waive Date *

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