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SouthSide Cycling Club Membership Form
TRIAL MEMBERSHIPS:
Trial memberships are for one month and may be only used once.
Trial memberships require creating a member account and signing the waiver.
Returning members may only use a trial membership for one month.
INDIVIDUAL MEMBERSHIPS:
Paid membership periods are for a full year from date of payment and requires you to create a member account and signing the waiver at this website.
FAMILY MEMBERSHIPS:
Family memberships requires first a current paid sponsoring individual membership.
The sponsor has the option to add up to three additional family members who must be either a spouse or dependent children under the age of 18 who reside in the same household and street address. Each paid family membership are for a full year from date of payment.
You must first pay the sponsoring individual membership. Sign out of the website, and follow the link to JOIN to this Membership form to add each additional family member. Each paid family membership requires creating or updating an existing member account and making payment through that unique account including signing the waiver.
First Name
*
Last Name
*
Email
*
Password
*
Confirm Password
*
Categories
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Single Rider Membership (1 Year)
- $30.00
Family Membership - $10 Each Additional Member (1 Year)
- $10.00
Welcome (1 Month Trial- May only be redeemed once, not valid for returning members.)
Returning Members (1 Month - May only be redeemed once.)
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Alabama
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Delaware
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Florida
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Hawaii
Idaho
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Indiana
Iowa
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Michigan
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Zip Code
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Phone
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Emergency Contact
*
Emergency Phone
*
I am a ...
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New Member
Returning Member
I am the family member sponsor
Family Membership Sponsors Name (Required)
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Waiver
*
Read disclaimer below. Fayette Biking for Life, Inc. D.B.A Southside Cycling Club (CLUB) RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT (\\\\\\\\\\\\\\\"AGREEMENT\\\\\\\\\\\\\\\") IN CONSIDERATION of being permitted to participate in any way in Southside Cycling Club (\\\\\\\\\\\\\\\"Club\\\\\\\\\\\\\\\") sponsored Bicycling Activities (\\\\\\\\\\\\\\\"Activity\\\\\\\\\\\\\\\") I, for myself, my personal representatives, assigns, heirs, and next of kin: 1. ACKNOWLEDGE, agree, and represent that I understand the nature of Bicycling Activities and that I am qualified, in good health, and in proper physical condition to participate in such Activity. I further acknowledge that the Activity will be conducted over public roads and facilities open to the public during the Activity and upon which the hazards of traveling are to be expected. I further agree and warrant that if at any time, I believe conditions to be unsafe, I will immediately discontinue further participation in the Activity. 2. FULLY UNDERSTAND that (a) BICYCLING ACTIVITIES INVOLVE RISKS AND DANGERS OF SERIOUS BODILY INJURY, INCLUDING VIRAL INFECTIONS, BACTERIAL INFECTIONS, AND OTHER COMMUNICABLE DISEASES AND ILLNESSES, PERMANENT DISABILITY, PARALYSIS AND DEATH (\\\\\\\\\\\\\\\"Risks\\\\\\\\\\\\\\\"); (b) these Risks and dangers may be caused by my own actions, or inactions, the actions or inactions of others participating in the Activity, the condition in which the Activity takes place, or THE NEGLIGENCE OF THE \\\\\\\\\\\\\\\"RELEASEES\\\\\\\\\\\\\\\" NAMED BELOW; (c) there may be OTHER RISKS AND SOCIAL AND ECONOMIC LOSSES either not known to me or not readily foreseeable at this time; and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I incur as a result of my participation or that of the minor in the Activity. 3. HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE the Club, their respective administrators, directors, agents, officers, members, volunteers, and employees, other participants, any sponsors, advertisers, and, if applicable, owners and lessors of premises on which the Activity takes place, (each considered one of the RELEASEES\\\\\\\\\\\\\\\" herein) FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON MY ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE \\\\\\\\\\\\\\\"RELEASEES\\\\\\\\\\\\\\\" OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS; AND I FURTHER AGREE that if despite this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT I, or anyone on my behalf, makes a claim against any of the Releasees, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES from any litigation expenses, attorney fees, loss, liability, damage, or cost which any may incur as the result of such claim. I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY PARTICIPATION IN THE ORGANIZED RIDE, CONSENT FREELY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID, THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT.
Read through the agreement.
I have read and agreed to the TERMS
*
Is the participant 18 or older?
*
18 or older
Under 18
Parent or Legal Guardian’s Signature - By providing your electronic signature you agree that you have the authority to register these participants and agree to the waiver(s) for them as their parent or legal guardian.
If registering a child under 18, you are consenting to the collection of the child's information that you are providing for the purposes of registration.
Parent's signature
Payment Details
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Do not COPY & PASTE the code, please type it into this field.
Price
$
Discount (-)
$
Total
no handling
$
Handling
$
Total Owed
$
Payment Method
The payment and credit card section is not visible because there is nothing owed or form fields have not been fully completed.
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Payable To:
Southside Cycling Club
Address:
60 Postal Parkway #73462, Suite 176, Newnan, GA, 30271
click the "submit" button to submit your order then send a check to (or pay in person at) the address above.
1. Venmo the total amount to the Phone #:
2. Make sure you enter the code,
50461
in "What's it for".
3. Click the "pay now" button.
Enter a Check Number
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