I understand and accept that railroad biking exposes me to many potential hazards that could result in personal injury and loss of or damage to property. I assume all risk of injury to myself and loss or damage to property arising out of railroad biking. I accept full responsibility for all damage, loss, or harm to my equipment or to me while participating in this activity. I release and discharge Wheels on Rails LLC, its partners, and employees, from and against any and all claims for injury, illness, death or loss or damage to property which I may suffer while railroad biking, regardless of whether such claims are based upon breach of contract, breach of warranty or any other legal theory. I grant to Wheels on Rails Traverse City LLC, and its officers, agents and employees the right to take photographs of me and my property in connection with the above-identified subject. I authorize Wheels on Rails Traverse City LLC, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Wheels on Rails LLC may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content. *

I agree to the terms of this form

By writing your name, this will be accepted as your signature. *

First Name

Last Name

Check below if rider is under 18 years of age.

Yes, rider is under 18 years

Name of Guardian if rider under 18

First Name

Last Name

Emergency Contact *

First Name

Last Name

Emergency Contact Phone *

(###)

###

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Today's Date *

MM

DD

YYYY

Date of Bike Tour *

MM

DD

YYYY

Time Slot *

9am

11am

1pm

3pm