MBHV 17th Annual Heroes Ride Registration Form
MBHV 17th Annual Heroes Ride Registration Form
*Rider/Operator's first and last name
*Home address including street
city, state and zip
*Cell number or Home phone
*Year, Color and Bike Manufacturer
*Passenger's first and last name
*Passenger's age if under 18
2024 Heroes Ride Online Registration!
You must fill out all sections of this form to participate. All rider/operators must fill out a form. If you have a passenger, fill out one form with their info as well.
*Please read and type in your signature and date*
*YOU MUST READ AND SIGN BELOW TO PARTICIPATE*
**Once you hit Submit, you will be taken to the Thank You page.**
Please click the pay button which will take you to the store
to order your banquet/auction/ride shirt selections and make payment.
Please click the submit button when you have finished filling in the form.
Please note that this info is secure! Only Debbie and Jeff will have access to your information.
*SIGNED:
*DATE:
*SIGNATURE OF PASSENGER:
*DATE SIGNED:
**All participants must signify their understanding of and agreement with the above by signing and dating here**
**Please go to the bottom of this page for a PRINT OUT version to download and fill out and send with a check.
PRINT OUT
Please click the link below to fill out and send with a check.
Please mail in the three pages.
Hit the back button after printing.
Please type NONE if doesn't apply
Please type NONE if doesn't apply
Please type NONE if doesn't apply
Please type NONE if doesn't apply
Please type NONE if doesn't apply
*PARTICIPANT'S NAME AS SIGNATURE*:
*DATE OF SIGNATURE:
*PASSENGER'S NAME AS SIGNATURE:
*SIGNATURE OF PARENT OR GUARDIAN IF UNDER 18:
*DATE OF SIGNATURE:
Please type NONE if doesn't apply
Please type NONE if doesn't apply
(Optional) How many Heroes Rides
Have you been on?
REGISTRATION, WAIVER AND RELEASE FORMS
Acknowledgment of Operator of Motorcycle Regarding Legal Registration, Licensing and Insurance Requirements as Conditions of
Participation in Event
''I, the undersigned, certify that the motorcycle listed above is legally registered in accordance with state, city, and/or local licensing and
registration requirements.
I further certify that I carry property and liability insurance for myself, my passengers, and the motorcycle which meets at least
the minimum state, city, and/or local insurance requirements.
I also certify that I carry a valid driver’s license with either a cycle endorsement or a valid Motorcyclist Temporary Instruction Permit
in accordance with state, city, and/or local laws.
I further certify that I have the legal right to utilize the listed motorcycle. I accept full responsibility for my safety and conduct,
and the safety and conduct of any who may be participating as my guest or passenger in this event.
I realize that these are requirements for my participation in this event.''
Please do not edit this form.
''Acknowledgment of Participation as Passenger Only
''I am participating as a passenger of the above participant, who has certified their compliance
with requirements of the event via a separate waiver form.
I will not be operating a motorcycle during this event, but am participating in this event as a passenger.''
Please do not edit this form.
WAIVER, RELEASE OF LIABILITY AND INDEMNIFICATION AND HOLD HARMLESS
AGREEMENT IN FAVOR OF MICHIGAN BIKERS HELPING VETERANS INC. (MBHV)
I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING AND/OR VOLUNTEERING IN THIS ACTIVITY OR EVENT,
including by way of example and not limitation, any risks that may arise from negligence or carelessness
on the part of the persons or entities being released, from dangerous or defective equipment or property owned,
maintained, or controlled by them, or because of their possibility liability without fault.
I certify that I am physically fit, have sufficiently prepared or trained for participation in the activity or event,
and have not been advised to not participate by a qualified medical professional.
I certify that there are no health related reasons or problems which preclude my participation in this activity or event.
I acknowledge that this Accident Waiver and Release of Liability Form will be used by the event holder, sponsors,
and organizers of the activity or event in which I may participate, and that it will govern my actions and responsibilities
at said activity or event.
In consideration of my application and permitting me to participate in this event, I hereby take action for myself,
my executors, administrators, heirs, next of kin, successors, and assigns as follows-
(A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to,
liability arising from the negligence or fault of the entities or persons released, for my death, disability,
personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including
my traveling to and from this event, THE FOLLOWING ENTITIES OR PERSONS- Michigan Bikers Helping Veterans, Inc.
and/or its directors, officers, employees, volunteers, representatives, and agents, the activity or event holders,
activity or event sponsors, activity or event volunteers
(B) I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in
paragraph (A) from any and all liabilities or claims made as a result of participation in this activity or event,
whether caused by the negligence of the release or otherwise.
I acknowledge that the Michigan Bikers Helping Veterans, Inc. and its directors, officers, volunteers, representatives,
and agents are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting
a specific event or activity on behalf of the Michigan Bikers Helping Veterans Inc.
I acknowledge that this activity or event may involve a test of a person’s physical and mental limits and may carry
with it the potential for death, serious injury, and property loss. The risks may include, but are not limited to,
those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic,
actions of other people including, but not limited to, participants, volunteers, spectators, event officials,
and/or event monitors of the event, and lack of hydration, and all other inherent risks foreseen and unforeseen.
These risks are not only inherent to participants, but are also present for volunteers.
I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident,
and/or illness during this activity or event.
I understand that at this event or related activities, I may be photographed. I agree to allow my photo, video,
or film likeness to be used for any legitimate purpose by the event holders, sponsors, organizers, and assigns.
The accident wavier and release of liability shall be construed broadly to provide a release and waiver to the
maximum extent permissible under applicable law.
''I, the undersigned, agree that the Michigan Bikers Helping Veterans, Inc. shall not be liable or responsible
for damage to property or injury to persons including myself during this event, even where the damage or injury
is caused by negligence. I understand and agree that participation in this event is voluntary, and is at my own risk.
I release and hold the MBHV Inc. officers and directors and the MBHV Inc. harmless for any injury loss to my
person or property that may result through my participation in this event. I understand that this means that
I agree not to sue the MBHV and/or its officers and directors, for any injury resulting to myself or my property
in connection with this event.'.
I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT.
I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL.
IN THE EVENT THIS COMPLETED FORM IS BEING SUBMITTED DIGITALLY WITH MY ELECTRONIC SIGNATURE,
I FURTHER CERTIFY SAME WILL BE CONSIDERED TO HAVE BEEN ADOPTED AND EXECUTED BY ME WITH THE
INTENTION TO SIGN THIS DOCUMENT AND WILL BE GIVEN FULL LEGAL FORCE AND EFFECT.
Please do not edit this form.