Ohio Association of Regular Baptist Churches

American Church Group--Ohio

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Participant Waiver Form OARBC Scholarship Bike Ride

Sponsor Information:

Name of sponsoring organization: Ohio Association of Regular Baptist Churches (OARBC)

Address: 360 College Hill Drive, Cedarville, Ohio 45314 Telephone: (937) 766-5913

Name of OARBC coordinators: Dave and Pat Warren  Telephone: (937) 532-8532 cell

Description of Activity: OARBC Scholarship Bike Ride.

Purpose:  Riders to raise college scholarship funds for young people heading for ministry.

Participation Fees: $25 per person includes T-Shirt - $50 per family includes 2 shirts - $100 per Youth / SS group incl 5 shirts

Date and location of activity: September 10, 2016 – Location to be indicated on Registration Form


Participant Information: (Each participant in a group must ).

Group Name [Family or Church]:                                                                                      City                                                                  

Name of participant:                                                                                                           HPhone:                                                           

Name of parents/guardian:                                                                                               Cell:                                                                     

Address:                                                                                                                             City                                                                    

Name of Insurance Company:                                                                                         Policy or Group number:                                                        


Participation Agreement

In consideration for the opportunity to participate in the “Activity” described above, the Participant (parent/guardian if Participant is a minor) acknowledges and accepts the risks of injury associated with participation in and transportation to and from the Activity. The Participant (or parent/guardian) accepts personal financial responsibility for any injury sustained during the Activity or during transportation to and from the activity, as well as for any medical treatment rendered to the Participant that is authorized by the Sponsor or its agents, employees, volunteers, or any other representatives (collectively referred to hereinafter as the “Sponsor”). Further, the Participant (or parent/guardian) releases and promises to indemnify, defend, and hold harmless the Activity Sponsor for any injury arising directly or indirectly out of the described Activity or transportation to and from the Activity, whether such injury arises out of the negligence of the Sponsor, or the Participant, or otherwise. If a dispute over this agreement or any claim for damages arises, the Participant (or parent/guardian) agrees to resolve the matter through a mutually acceptable alternative dispute resolution process. If the Participant (or parent/guardian) and the Sponsor cannot agree upon such a process, the dispute will be submitted to a three-member arbitration panel of the American Arbitration Association for final resolution.



Signature of Participant                                                                                                                                                     Date:                                                  


Signature of parents or guardian if participant is a minor)  ------------------------------------------------------------------------------  Date:                                                 

17 West Maple Drive | Phone: (863) 368-1617 |chuckpausley@oarbc.org

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