WAIVER YOUR GROUP NAME or organization * Example: "The Stowe Family", "The Stowe Foundation", "Mr. & Mrs. Stowe Tour" or "The Stowe Company Tour" PLEASE ENTER THE DATE OF YOUR EVENT * MM DD YYYY Please List Additional Participants / MINORS BEING SIGNED FOR: RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, INDEMNITY AGREEMENT (“AGREEMENT”), and promotional usage approval by 4points vt * IN CONSIDERATION OF MYSELF OR MY CHILD BEING PERMITTED TO PARTICIPATE IN A MOUNTAIN BIKING AND/OR BREWERY TOUR CONDUCTED BY 4 POINTS VT LLC (“ACTIVITY”) I, FOR MYSELF, MY SPOUSE, MY PERSONAL REPRESENTATIVES, ASSIGNS, HEIRS, AND NEXT OF KIN: IF PARTICIPATING IN A BREWERY TOUR, ACKNOWLEDGE, AGREE, AND REPRESENT THAT I UNDERSTAND THE NATURE OF ALCOHOL CONSUMPTION ACTIVITIES (DEFINED AS ANY ACTIVITY IN WHICH AN INDIVIDUAL TASTES, CONSUMES, OR BUYS ALCOHOL WHILE ON A TOUR) AND THAT I AM QUALIFIED, IN GOOD HEALTH, OF LEGAL DRINKING AGE (21 YEARS OR OLDER), AND IN PROPER PHYSICAL CONDITION TO PARTICIPATE IN SUCH ACTIVITY. 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. IF PARTICIPATING IN A BREWERY TOUR, FULLY UNDERSTAND THAT: (A) ALCOHOL CONSUMPTION ACTIVITIES INVOLVE RISKS AND DANGERS OF SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS AND DEATH (“RISKS”); (B) THESE RISKS AND DANGERS MAY BE CAUSED BY FACTORS INCLUDING, BUT NOT LIMITED TO: 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. IF PARTICIPATING IN A BREWERY TOUR, ACKNOWLEDGE AND UNDERSTAND DRINKING AND DRIVING IS DANGEROUS TO MY SAFETY AND THE SAFETY OF OTHERS. I FURTHER ACKNOWLEDGE THAT, IF NECESSARY, I WILL TAKE ADVANTAGE OF 4 POINTS VT LLC’S SERVICE TO PROVIDE TRANSPORTATION TO MY DESTINATION OR ARRANGE FOR TRANSPORTATION TO MY ULTIMATE DESTINATION. I FULLY ACCEPT AND ASSUME ALL RISKS AND RESPONSIBILITY FOR ANY INJURY I INCUR OR CAUSE TO OCCUR TO OTHERS AS A RESULT OF MY FAILURE TO TAKE CAUTION WHILE OPERATING A VEHICLE AFTER PARTICIPATING IN THE ACTIVITY. IF PARTICIPATING IN A MOUNTAIN BIKING TOUR, I ACKNOWLEDGE AND UNDERSTAND THAT MOUNTAIN BIKING IS A DANGEROUS SPORT AND THAT SERIOUS ACCIDENTS AND DEATH OCCASIONALLY OCCUR DURING MOUNTAIN BIKING ACTIVITIES. KNOWING THE RISKS OF MOUNTAIN BIKING ACTIVITIES, I HEREBY AGREE TO ASSUME THOSE RISKS. FURTHERMORE, I GIVE MY CONSENT FOR THE ADMINISTRATION OF ANY EMERGENCY MEDICAL TREATMENT DEEMED NECESSARY, IN THE EVENT THAT SAME IS REQUIRED, AS A RESULT OF MY OR MY CHILD'S PARTICIPATION IN MOUNTAIN BIKING ACTIVITIES ORGANIZED BY 4 POINTS VT LLC. I HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE 4 POINTS VT LLC, ITS OFFICERS, DIRECTORS AND MEMBERS, ADMINISTRATORS, AGENTS, OFFICERS, MEMBERS, VOLUNTEERS, CONTRACTORS 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 ACCOUNT OF DEATH OR INJURY TO MYSELF, MY CHILD, MY PROPERTY, OTHERS, OR OTHERS' PROPERTY, EVEN INJURY RESULTING IN DEATH, WHETHER CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE ACTS OR OMISSIONS, INCLUDING, WITHOUT LIMITATION, RESCUE OPERATIONS, OF THE RELEASEES OR OTHERWISE WHILE I AM PARTICIPATING IN THE ACTIVITY. I AGREE THAT IF, DESPITE THIS RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT I, ANYONE ON MY BEHALF, OR ANYONE HARMED BY MY ACTIONS OR OMISSIONS 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 AGREE AND ACKNOWLEDGE THAT 4 POINTS VT LLC HAS THE RIGHT TO REMOVE ME FROM THE ACTIVITY AND PREVENT MY FURTHER PARTICIPATION IN THE ACTIVITY IF MY CONDUCT IS DISORDERLY OR INTERFERES WITH OTHERS' ENJOYMENT OF THE ACTIVITY. I AGREE AND ACKNOWLEDGE THAT IF I OR MY CHILD ARE USING AN E-BIKE OWNED BY 4 POINTS VT LLC, THE EBIKE WILL BE RETURNED IN THE SAME CONDITION AS WHEN GIVEN TO ME OR MY CHILD, EXCEPTING ORDINARY WEAR AND TEAR. I WILL BE RESPONSIBLE FOR THEFT OR ANY DAMAGE TO THE E-BIKE DURING MY OR MY CHILD’S PERIOD OF USE. I GIVE 4 POINTS VT LLC AUTHORIZATION TO CHARGE MY CREDIT CARD FOR THE AMOUNT OF ANY DAMAGE OR REPLACEMENT OF THE E-BIKE, AND UNDERSTAND THAT I WILL BE RESPONSIBLE FOR ALL LOSSES RESULTING FROM ANY SUCH THEFT OR DAMAGE, INCLUDING REASONABLE ATTORNEY’S FEES, IF APPLICABLE. I HEREBY GRANT PERMISSION FOR MY PICTURE AND/OR VIDEO TO BE USED BY 4 POINTS VT LLC, its partners, and/or the media for uses included but not limited to programming, media, or promotional purposes. This is a complete release of all claims, whether legal or equitable, in connection with said photos and/ or videos. I agree to all of the terms and conditions within this waiver and understand these items are required to participate Please use your FULL legal name. * First Name Last Name Please enter YOUR email address. * PLEASE ENTER YOUR PHONE NUMBER * (###) ### #### Please enter your emergency contact name * First Name Last Name Please enter your Phone Number * (###) ### #### Do any of the following conditions apply to you? * No medical conditions Asthma or wheezing Fainting, seizures or blackouts Brain, spinal cord or nervous disorder Heart disease of any kind Chest surgery Recurrent ear problems when flying Chronic bronchitis or persistent chest complaint Tuberculosis or other long-term lung disease Chronic sinus condition Breathlessness Thank you!
