Please print, sign and mail to Andy Clark, 3542 Sliver Leaf Ct, Ft Collins CO 80526

Link to PDF version

Waiver and Release from Liability

I ___________________ (please print your name) fully understand the risks inherent in any fitness or cycling program and accept personal responsibility for my own bodily injury, death, or property losses, which may occur, as a result of my being a part of a coaching program, group ride, race or any other interactions with Ciclismo Coaching or their associates. I hereby indemnify and hold harmless Ciclismo Coaching and any of their associates from loss, liability, damage, or any other cost that I may incur due to my participation in my coaching program or any related activities. I have read and voluntarily signed the waiver and release from liability, and further agree that no oral representation, statements or inducements apart from foregoing written agreement have been made.

Signature_____________________________Date_________________________

Andy Clark___________________________Date_________________________

Thank you for your commitment.

Andy Clark

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