Fill and Sign the Agreement Bicycle Form

A GREEMENT TO RENT BICYCLE AND RELEASE OF LIABILITY Agreement made on the ___ day of __________, 20___, between ________________________ of ________________________________________________ (street address, city, county, state, zip code) , referred to herein as Renter , and ________________________, a company organized and existing under the laws of the state of ___________________, with its principal office located at ________________________ ________________________ (street address, city, county, state, zip code) , referred to herein as Company. Whereas the undersigned Renter wishes to rent from Company the bicycle described as follows and hereinafter referred to as Bicycle: Manufacturer:_________________________ Make/Model: ________________________ Serial Number (if any): ________________ Now, therefore, for and in consideration of the mutual covenants contained in this agreement, and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties agree as follows: 1. The term of this rental agreement shall commence on _______________________ (date and time), and terminate on ________________________ (date and time). Renter agrees to pay Company the sum of $____________, in advance, as rent. 2. Renter shall use Bicycle in a careful and proper manner, shall comply with all applicable laws and regulations, and shall maintain the Bicycle in good repair and condition. Renter assumes all risks of loss and damage to the Bicycle from any cause whatsoever and agrees that the Bicycle will be returned to Renter in the same appearance and condition as when received, ordinary wear and tear excepted. 3. Renter acknowledges that cycling is an inherently dangerous sport in which Renter participates at his/her own risk; and further acknowledges that Company will not rent a Bicycle to me unless I sign this agreement which includes a waiver, release and assumption of risk agreement. 4. T he undersigned does hereby agree to, covenant to, and represent the following: a. I, on behalf of myself, my heirs, assignees and personal representatives, do release and forever discharge Company , its employees, officers, and agents (all of which are hereinafter jointly and severally referred to as Released Parties ) from any and all liability, claim, loss, cost or expense, arising directly or indirectly from, or attributable in any legal way to, any negligence, action or omission to act of Released Parties that results from my rental of said Bicycle. b . I, on behalf of myself, my heirs, assignees and personal representatives, do hereby waive and promise not to sue on any such claims against Released Parties arising directly or indirectly from or attributable in any legal way to, any negligence, action or omission to act of Released Parties that results from my rental of said Bicycle. c . I currently have no known physical or mental condition that would impair my capacity to safely use said Bicycle as intended or expected except for (specify) ____________________________________________________________________ If none write NONE. d . I hereby assume all risks associated with using this Bicycle and I do release the Released Parties for any injuries to me that may occur during my use of said Bicycle . I certify that the information on this document, as entered by me, is truthful. e . I, on behalf of myself, my heirs, assignees and personal representatives, agree to indemnify and save Released Parties harmless for any and all liability, claim, loss, cost or expense, arising directly or indirectly from, or attributable in any legal way to, my actions or any negligence, action or failure to act of Released Parties that results from my rental of said Bicycle . WITNESS our signatures on this the ____ day of ___________, 20____. ________________________ ________________________ By______________________ RENTER AGREEMENT AND CONSENT OF PARENT OR GUARDIAN OF MINOR I, as parent or guardian of ________________________ (Name of Minor) , represent to the Released Parties that the facts in this document concerning my child or ward are true. I give my permission for my child or ward to rent a bicycle from Company and further, in consideration of renting said Bicycle to my child or ward, I agree individually and on behalf of my child or ward, to the terms of the above Waiver, Release and Assumption of Risk. WITNESS my signature on this the ____ day of ___________, 20_____. ________________________ Parent or Guardian (Optional) BICYCLE CHECKED OUT ON THE ________ DAY OF __________, 20_____. ITEM Good Fair Poor No Comment Seat ( ) ( ) ( ) ( ) ___________________________ Front Tire ( ) ( ) ( ) ( ) ___________________________ Back Tire ( ) ( ) ( ) ( ) ___________________________ Fenders ( ) ( ) ( ) ( )______________________ Spokes ( ) ( ) ( ) ( )_______________________ Handle Bars ( ) ( ) ( ) ( ) __________________________ Frame ( ) ( ) ( ) ( ) ___________________________ Basket ( ) ( ) ( ) ( ) ___________________________ Flag ( ) ( ) ( ) ( ) ___________________________ Pedals ( ) ( ) ( ) ( ) ___________________________ Chain ( ) ( ) ( ) ( ) ___________________________ Brakes ( ) ( ) ( ) ( ) ___________________________ Kick-Stand ( ) ( ) ( ) ( ) ___________________________ Cleanliness ( ) ( ) ( ) ( ) ___________________________ Other _______ ( ) ( ) ( ) ( ) ___________________________ I agree that the Bicycle is in the condition set forth above ____________________________________________ _________________ Renter = s Signature Date BICYCLE CHECKED IN ON THE ________ DAY OF __________, 20_____. ITEM Good Fair Poor No Comment Seat ( ) ( ) ( ) ( ) ___________________________ Front Tire ( ) ( ) ( ) ( ) ___________________________ Back Tire ( ) ( ) ( ) ( ) ___________________________ Fenders ( ) ( ) ( ) ( )______________________ Spokes ( ) ( ) ( ) ( )_______________________ Handle Bars ( ) ( ) ( ) ( ) __________________________ Frame ( ) ( ) ( ) ( ) ___________________________ Basket ( ) ( ) ( ) ( ) ___________________________ Flag ( ) ( ) ( ) ( ) ___________________________ Pedals ( ) ( ) ( ) ( ) ___________________________ Chain ( ) ( ) ( ) ( ) ___________________________ Brakes ( ) ( ) ( ) ( ) ___________________________ Kick-Stand ( ) ( ) ( ) ( ) ___________________________ Cleanliness ( ) ( ) ( ) ( ) ___________________________ Other _______ ( ) ( ) ( ) ( ) ___________________________ I agree that the Bicycle is in the condition set forth above ____________________________________________ _________________ Company Date