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Liability Discharge

I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL
ACTIVITIES ASSOCIATED WITH RIDING, 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 possible liability without fault.
I certify that I am physically fit, have sufficiently prepared or trained for participation in this
activity, 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.
In consideration of my application and permitting me to participate in this activity, 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 activity, THE
FOLLOWING ENTITIES OR PERSONS: URBAN MOBILITY BRUSSELS and/or their
admnistrator, officers, employees, volunteers, representatives, and agents, and the activity
holders, sponsors, and volunteers;
(B) INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or
persons mentioned in this paragraph from any and all liabilities or claims made as a result of
participation in this activity, whether caused by the negligence of release or otherwise.
I acknowledge that URBAN MOBILITY BRUSSELS and their administrator, 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 activity on their behalf.
I acknowledge that this activity may involve a test of a person’s physical and mental limits
and carries with it the potential for death, serious injury, and property loss. The risks include,
but are not limited to, those caused by terrain, facilities, temperature, weather, condition of
participants, equipment, vehicular traffic, lack of hydration, and actions of other people
including, but not limited to, participants, volunteers, monitors, and/or producers of the
activity. These risks are not only inherent to participants, but are also present for others.
I hereby consent to receive medical treatment which may be deemed advisable in the event of
injury, accident, and/or illness during this activity.
I understand while participating in this activity, I may be photographed. I agree to allow my
photo, video, or film likeness to be used for any legitimate purpose by the activity holders,
producers, sponsors, organizers, and assigns.
The Accident Waiver and Release of Liability Form shall be construed broadly to provide a
release and waiver to the maximum extent permissible under applicable law.