ANGLAIS

As part of the Montreal Metropolitan Challenge on Sunday, May 29, 2016

Les champs marqués d'un * sont obligatoires / Fields marked with an * are required



In consideration of my registration for participation in Pedal for LÉGER supporting the LÉGER FOUNDATION, I hereby agree, as a participant or parent/guardian of the minor identified below and on behalf of my respective heirs, executors and administrators, to release from all liability the LÉGER FOUNDATION, as well as any organization, certifying body and corporate sponsor from any and all actions, causes of action, claims or claims for damages, liability, indemnity, costs, interest and other expenses (including legal fees) for any personal injury, loss or damage whatsoever, relating to myself, my property or the participating minor identified below or his/her property, for whatever reason, arising from participation in Pedal for LÉGER. I guarantee that I and the participating minor identified below are physically fit and have the necessary physical ability to participate in Pedal for LÉGER. I state that I have carefully read this Disclaimer, Waiver of Liability and Indemnity Agreement and fully understand its terms. I also understand that I give up substantial rights by signing below and knowing this, sign it voluntarily, without any inducement, assurance or warranty of any kind. My signature amounts to a full and unconditional waiver of liability to the fullest extent of the law.

Assignment of Rights: Moreover, I authorize the LÉGER FOUNDATION to make use of any photo taken or video made of myself or the participating minor identified below during our participation in the activity. The LÉGER FOUNDATION may also reproduce these photos or videos in any media, communications, Web sites or special promotions from time to time, as long as the LÉGER FOUNDATION considers such usage appropriate.

Communication: All personal information disclosed in this form will be treated confidentially. We will use your personal information to answer any request you may forward to us, to present our programs and to solicit your financial support.

■ Terms and Conditions of LÉGER FOUNDATION

■ Jersey Size Guide