GRAND STRAND

GRAND STRAND

CYCLING ASSOCIATION

Grand Strand Cycling Association (GSCA) was established to promote safer and more accessible cycling conditions in South Carolina, and to educate cyclists and the general public in the multiple uses of our roadways. The club is open to ALL levels of cyclists and ALL ages.

GSCA MEMBERSHIP APPLICATION

NAME

ADDRESS

CITY STATE ZIP

PHONE NUMBER E-MAIL

TYPE OF MEMBERSHIP

___NEW MEMBERSHIP, ___RENEWAL ___Age (if under 18)

__INDIVIDUAL ($20), ____FAMILY ($30). ____STUDENT ($10)

BIKING INTEREST: (check all that apply)

___SOCIAL RIDES___DAY RIDES ___RACING ___TRIATHLONS ___TOURING__MOUNTAIN BIKING ___TIME TRIALS ___SOCIAL EVENTS

I CAN SUPPORT THE CLUB BY ASSISTING WITH: (check all that apply)

___Leading rides___Being a club officer ___Club meetings___Publicity ___Newsletter/ website articles

___Social Events ___Time trials ___Century rides

Signatures: (Parent or Guardian if under 18)

WAIVER and RELEASE: In signing this release and in consideration of my (our) membership, I (we) agree to absolve and hold harmless the Grant Strand Cycling Association (GSCA) and its officers, members, and any and all persons connected with the GSCA in anyway whatsoever, collectively, and singularly. I (we) further intending to be legally bound, release and discharge any and all claims for damages for death, personal injury or property damage, which I (we) may have, or which may hereafter accrue to me, as a result of my participation in rides and events. This waiver and release is intended to discharge in advance GSCA, its officers, ride leaders, agents and members from and against any and all liability arising out of or connected in any way with my participation in Club rides and events, even though that liability may arise out of negligence or carelessness on the part of GSCA. its officers, ride leaders, agents and/or members. I (we) further understand that serious accidents occasionally do occur on events and that participants occasionally sustain mortal or serious personal injuries, and/or property damage, as a consequence. Knowing the risks, nevertheless, I (we) hereby agree to assume those risks and to release and hold harmless the GSCA. its officers, ride leaders, agents and members who (through negligence or carelessness) might otherwise be liable to me for damages and injuries. It is further understood and agreed that this waiver and release and assumption of risk is binding on my estate, my heirs, and assigns and can not be changed orally.

Signature:___________________________Date:______________

Return or mail to: Bicycles N-Gear 515C Highway 501 Myrtle Beach, SC 29577