CINCINNATI CYCLE CLUB, INC.
RIDER SIGN-IN /RELEASE FORM

Ride/Event:__________________________________ Date:____/____/______

Leader: ___________________________________ Co-Leader:_______________________________
In signing this release for myself or the named rider if under 16years old (Children under 16 must ride with a responsible adult) I acknowledge that I have read and understand its intent. I understand that the Cincinnati Cycle Club, Inc., its Officers, Ride Leaders, and Members are not insurers of my personal safety during this ride or event. I thus agree to hold them harmless from any liability arising from having sustained any property loss, damage, or personal injury because of negligence in participating in or arranging this ride/event. I hereby consent to and permit emergency medical treatment if needed. I shall abide by all traffic laws and regulations. I shall practice courtesy and safety in cycling at all times. I AGREE TO WEAR AN ANSI OR SNELL APPROVED BICYCLING HELMET WHILE RIDING ON THIS RIDE AND CONFIRM MY ACKNOWLEDGMENT BY SIGNING THIS RELEASE

RIDER'S NAME RIDER'S SIGNATURE EMERGENCY PHONE NO. CCC Member?