Bicycle Loaner Program Form

NOTICE TO THE MINOR CHILD’S (UNDER 18 YEARS OF AGE) NATURAL GUARDIAN

READ THIS FORM COMPLETELY AND CAREFULLY.  YOU ARE AGREEING TO LET YOUR MINOR CHILD ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY.  YOU ARE AGREEING THAT, EVEN IF THE CITY OF PUNTA GORDA, TEAM PUNTA GORDA, AND THEIR OFFICERS, EMPLOYEES, VOLUNTEERS, AND AGENTS (COLLECTIVELY, “RELEASEES”) USE REASONABLE CARE IN PROVIDING THIS ACTIVITY, THERE IS A CHANCE YOUR CHILD MAY BE SERIOUSLY INJURED OR KILLED BY PARTICIPATING IN THIS ACTIVITY BECAUSE THERE ARE CERTAIN DANGERS INHERENT IN THE ACTIVITY WHICH CANNOT BE AVOIDED OR ELIMINATED.  BY SIGNING THIS FORM YOU ARE GIVING UP YOUR CHILD’S RIGHT, AND YOUR RIGHT TO RECOVER FROM THE RELEASEES IN A LAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH, TO YOUR CHILD OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART OF THE ACTIVITY.  YOUR HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM, AND THE RELEASEES HAVE THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS FORM.

Minor Child’s Natural Guardian must complete the section Below

BICYCLE USERS PARENTAL CONSENT, RELEASE OF LIABILITY,

COVENANT NOT TO SUE, AND HOLD HARMLESS

In consideration of my child’s borrowing of a bicycle from the Punta Gorda bicycle loan program, (hereafter, the “Activity”), the undersigned agrees as follows:

1. I am the parent or legal guardian of minors mentioned on this form, who are under the age of eighteen (18) years. I understand that my child’s participation in the Activity may include risks and hazards. I am aware of the risks and hazards inherent in my child’s participation in the Activity, and recognizing those risks and hazards, I hereby give my consent and approval to my child’s participation in the Activity.

2. On behalf of my child and myself, I hereby release the City of Punta Gorda, Florida, and TEAM Punta Gorda, and their officers, employees, volunteers, and agents (collectively, “Releasees”) from any and all liability for any and all claims and causes of action which I or my child may hereafter have on account of any and all injuries and/or damage that I or my child may sustain, or any loss of any other sort, arising out of or relating to my child’s or my participation in the Activity, or incidental thereto, whether caused by the negligence of the Releasees or any other person. In addition, on behalf of my child and myself, I covenant and agree not to sue any of the Releasees, and agree to forever hold them and each of them harmless, from any liability, claims, demands, actions, or causes of action whatsoever arising from my child’s or my participation in the Activity, whether such liability, claims, demands, or actions are the result of the negligence of the Releasees or any other person. This release of liability, covenant not to sue, and hold harmless agreement shall be binding upon me, my child, my heirs, and/or my child’s heirs, executors, administrators, personal representatives, and assigns, and shall inure to the benefit of the Releasees and their successors and assigns.

I hereby agree to indemnify the Releasees and to assume and be responsible for all harm, injury or damage caused by me or my child to any of the Releasees, the Releasees’ property or equipment, other persons or other personal property used in conjunction with the Activity.

BICYCLE USERS LIABILITY RELEASE FORM

In consideration for being permitted to participate as a Borrower in the Punta Gorda bicycle loan program, I understand and agree to the following terms and conditions: 

1. I agree to leave a copy of a valid credit card with the sponsoring location and do hereby authorize charges as specified below.
2. I am at least 18 years old and agree to leave a copy of my driver’s license or government issued identification card. (Borrowers under the age of 18 years must be accompanied by an adult, and the attached “Parental Consent, Release of Liability, Covenant Not To Sue and Hold Harmless” must be signed and shall be a part of this Agreement.)
3. I have made a full inspection of the bicycle and it is in safe and serviceable condition.
4. I will return the bicycle thirty minutes before sunset on the day of the rental and to the same location I departed from. Failure to do so will authorize a $250 charge to my credit card.
5. I understand that I will be liable for costs up to $250 in the event that the bicycle is damaged, lost, or stolen during my use of it.
6. I understand that I will be liable for replacement costs of any equipment provided with the bicycle, including a helmet or bicycle lock, if it is lost or damaged.
7. I will not use the bicycle while under the influence of any drug, combination of drugs, legal or not, or alcohol that might affect my coordination or judgment.
8. Because of the dangers inherent to riding a bicycle, I recognize the importance of following all city, state, and federal laws and regulations regarding the operation of bicycles. In addition, I recognize that the use of a helmet is required at all times during operation of the bicycles used in this program.
9. I acknowledge that I am in good physical condition and do not know of any condition or reason why I should not be able to operate the bicycle provided through the City of Punta Gorda Bicycle Loaner Program.

By signing this Lending Agreement, the Borrower gives assent to all of the foregoing terms and conditions.  Furthermore, the Borrower agrees that bicycling is a dangerous activity and carries with it certain hazards and risks of which the Borrower is aware. The Borrower, on behalf of himself/herself, his/her heirs, executors, administrators, personal representatives and assigns, hereby releases the City of Punta Gorda, TEAM Punta Gorda, and their officers, employees, volunteers and agents (collectively “Releasees”) from any and all liability for any and all claims and causes of action which Borrower may hereafter have on account of any and all injuries and/or damage that the Borrower may sustain, or any loss of any other sort, arising out of or relating to usage of the bicycle, whether caused by the negligence of the Releases or any other person. In addition, the Borrower covenants and agrees not to sue any of the Releases, and agrees to forever hold them and each of them harmless, from any liability, claims, demands, actions, or causes of action whatsoever arising from the usage of the bicycle, whether such liability, claims, demands, or actions are the result of the negligence of the Releases or any other person. This release of liability, covenant not to sue, and hold harmless agreement shall be binding upon the Borrower, the Borrower’s heirs, executors, administrators, personal representatives, and assigns, and shall inure to the benefit of the Releases and their successors and assigns.

Borrower agrees to indemnify the Releases and to assume and be responsible for all harm, injury or damage caused by the Renter to any of the Releases, the Releases’ property or equipment, other persons or other personal property used in conjunction with usage of the bicycle.

I understand that this is an ASSUMPTION OF ALL RISKS AND A GENERAL WAIVER OF ANY AND ALL CLAIMS OR CAUSES OF ACTION which I may have or might accrue as a result of the foregoing activities.