Join the Santa Cruz County Cycling Club

This page will not work correctly without Javascript enabled for your browser. To join or renew on-line click here, otherwise you can simply print the SCCCC Membership Application Form and mail it to us with your check.

The rest of this page requires Javascript....

By completing the on-line Paypal checkout process, I agree to the 'Release and Waiver of Liability' on the SCCCC Membership Application Form and verify I am of age 18 years or older. If you do not wish to join or renew on-line, simply print the above Application form and mail it to us with your check.

Check one * New Member Renewal or Upgrade
Please indicate if this is a renewal/upgrade to family membership or a new membership application

First Name: *
Last Name: *
Above person: *
Contact Email: *
Address: *

City: *
State: *
Zip: *
Ride Cell Phone:
Contact Phone: *

Add me to SCCCC Email List:*
Include me in club roster:*
Newsletter via US Mail: ($5/yr)*
Family Membership:*

Family Information

2nd Member First Name: *
2nd Member Last Name: *
Above person: *
2nd Member Contact Email: *
2nd Member Ride Phone:
2nd Member Contact Phone: *
Children Names:

Please read the waiver carefully: (version for printing) . Each Adult must individually indicate their agreement below their name. For minors under 18 years old, you must complete a paper application form and mail it to us.

By selecting AGREE under your name above for the liability waiver, you agree, warrant and covenant as follows: League of American Bicyclists (LAB) RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, INDEMNITY, AND PARENTAL CONSENT AGREEMENT (“Agreement”) Each applicant for membership shall read and sign the following Release Agreement: IN CONSIDERATION of being permitted to participate in any way in Santa Cruz County Cycling Club ("Club") sponsored Bicycling Activities ("Activity") I, for myself, my personal representatives, assigns, heirs, and next of kin: 1. ACKNOWLEDGE, agree, and represent that I understand the nature of Bicycling Activities and that I am qualified, in good health, and in proper physical condition to participate in such Activity. I further acknowledge that the Activity will be conducted over public roads and facilities open to the public during the Activity and upon which the hazards of traveling are to be expected. I further agree and warrant that if, at any time, I believe conditions to be unsafe, I will immediately discontinue further participation in the Activity. 2. FULLY UNDERSTAND that (a) BICYCLING ACTIVITIES INVOLVE RISKS AND DANGERS OF SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS AND DEATH ("Risks"); (b) these Risks and dangers may be caused by my own actions or inactions, the actions or inactions of others participating in the Activity, the conditions in which the Activity takes place, or THE NEGLIGENCE OF THE "RELEASEES" NAMED BELOW; (c) there may be OTHER RISKS AND SOCIAL AND ECONOMIC LOSSES either not known to me or not readily foreseeable at this time; and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I may incur as a result of my participation in the Activity. 3. HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE the Club, the LAB, its respective administrators, directors, agents, officers, members, volunteers, and employees, other participants, any sponsors, advertisers, and, if applicable, owners and lessors of premises on which the Activity takes place, (each considered one of the "RELEASEES" herein) FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON MY ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE "RELEASEES" OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS. And, I FURTHER AGREE that if, despite this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT I, or anyone on my behalf, makes a claim against any of the Releasees, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES from any litigation expenses, attorney fees, loss, liability, damage, or cost which any may incur as the result of such claim. I AM 18 YEARS OF AGE OR OLDER, HAVE READ AND UNDERSTAND THE TERMS OF THIS AGREEMENT, UNDERSTAND THAT I AM GIVING UP SUBSTANTIAL RIGHTS BY SIGNING THIS AGREEMENT, HAVE SIGNED IT VOLUNTARILY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW. I AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID, THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT.

Membership Options: *

Press "Add to Cart" ONCE when form is complete.

Instructions

After entering the membership information, press the Add to Cart button ONCE to display your shopping cart. Checkout payment can be made by credit card or through a paypal account, and is securely handled by Paypal. If you would like to receive the Road Runner by US Mail, check the Newsletter via U.S. Mail button above (additional $5/yr postage charge). Note that Upgrades from Individual membership to Family membership cannot change the Newsletter setting. You can do that here.

Need help? Check our Membership FAQ
Email help request for this form.

webmaster@santacruzcycling.org