Register

I acknowledge that by signing this application, I am releasing the Rouge Hill Cycling Club and its directors, officers, managers, and members from liability. This release is with legal consequences and I have been advised to read it carefully before signing. I acknowledge that cycling is an inherently dangerous sport and I fully realize the dangers of participating in bicycle rides specifically training, racing and motor pacing and fully assume the risks associated with participation including, by way of example, and not limited to the following: the dangers of colliding with pedestrians, cars and other riders. I understand and agree that situations can arise during the training rides, instruction and races, which are beyond the immediate control of the club and race officials or organizers, and I must continue to ride in a manner that is not endangering to myself or others. I accept responsibility for the condition and safety of my equipment such as the bicycle and all of its components, wheels and tires. I will wear an ANSI approved hard shell helmet on all training rides and while participating at coaching or instruction clinics. This agreement may not be modified orally, and a waiver of any provision shall not be construed as a modification of any other provision.

In addition, I accept the Rouge Hill Cycling Club's Code of Conduct which applies to all members of the Rouge Hill Club (Rouge Hill Club Members) and every person who is associated (such as friend, relative, coach) with a member regardless whether that person is a member of the Rouge Hill Club. A Rouge Hill Member includes a Rouge Hill Club team member (Rouge Hill Team Members).



Personal Information
First Name
Last Name
Address
City
Province
Postal Code
Phone Number
Email
Confirm Email
Birth Date
Gender	Male Female

Emergency Contact Name
Emergency Contact Telephone

Membership Options
Option A: Basic Club Membership, Includes Cycling Ontario Insurance $150.00 CAD
Option B: Race License Club Membership (requires Cycling Ontario Race License) $110.00 CAD
Option C: Affiliate Membership for riders from other clubs (club name required) $40.00 CAD

Cycling Ontario Race License #
Name of Former Club
Jersey Size

Donations
The Rouge Hill Cycling Club is honoured to support the Heart & Stroke Foundation. A donation as small as $25 will make a difference and your help is appreciated. You will recieve a tax receipt from the Heart & Stroke Foundation if requested.
Donation Amount
$25.00 CAD
$50.00 CAD
$75.00 CAD
$100.00 CAD
$250.00 CAD
$500.00 CAD
Tax Receipt Requested	Yes No

Event Waiver and Indemnity
RELEASE, INDEMNITY and CODE OF CONDUCT (Please read carefully) I acknowledge that by signing this application, I am releasing the Rouge Hill Cycling Club and its directors, officers, managers, and members from liability. This release is with legal consequences and I have been advised to read it carefully before signing. I acknowledge that cycling is an inherently dangerous sport and I fully realize the dangers of participating in bicycle rides specifically training, racing and motor pacing and fully assume the risks associated with participation including, by way of example, and not limited to the following: the dangers of colliding with pedestrians, cars and other riders. I understand and agree that situations can arise during the training rides, instruction and races, which are beyond the immediate control of the club and race officials or organizers, and I must continue to ride in a manner that is not endangering to myself or others. I accept responsibility for the condition and safety of my equipment such as the bicycle and all of its components, wheels and tires. I will wear an ANSI approved hard shell helmet on all training rides and while participating at coaching or instruction clinics. This agreement may not be modified orally, and a waiver of any provision shall not be construed as a modification of any other provision. In addition, I accept the Rouge Hill Cycling Club's Code of Conduct which applies to all members of the Rouge Hill Club (Rouge Hill Club Members) and every person who is associated (such as friend, relative, coach) with a member regardless whether that person is a member of the Rouge Hill Club. A Rouge Hill Member includes a Rouge Hill Club team member (Rouge Hill Team Members).
I have read and agree to the release and indemnity as described above.