Back Roads Century Volunteer Form

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Volunteer for 2019 Back Roads Century and get a $25 Registration Rebate!

We need help before and during the cycling weekend. If you or your friends or family are interested in volunteering, fill out the form below. Volunteering is a great way to meet fellow cyclists and have fun. What's better than having hundreds of riders telling you "thank you" all day long? This is a great way to give back to the Potomac Pedalers, the cycling community and to help us ensure the event runs smoothly.

If you're registered to ride and help for 4 (or more) hours, you'll get a $25 rebate after the event.

Some volunteers shifts leave you free on Ride Weekend.
Please complete the Volunteer Form below. Our Volunteer Coordinator will contact you to confirm your position and time.
Some positions require a limited number of volunteers and will be filled on a “first to sign up” basis. We hope you will be flexible!
All volunteers will receive a free “BRC Volunteer T-shirt” and are welcome to join us at the Sunday post-ride party!

If you have questions, please contact Monique Sears, mrsearsklm@gmail.com.

Fill out the form below to sign up for a Back Roads Century Volunteer Position.

First Name *

Last Name *

Email Address *

Phone *

Are you a member? *

Yes

Route you plan on riding: *

I do not plan on riding. I’m happy to volunteer to support Potomac Pedalers!!

I plan on riding and registering for the ride.

Emergency Contact Name: *

Emergency Contact Phone Number: *

PPTC Participation Agreement: Release and Waiver

In consideration for being permitted to participate in a bicycle ride, event or other activity sponsored by or associated with Potomac Pedalers Touring Club, Inc. (the “Club”) I, myself, my personal representatives, assigns, heirs and next of kin, agree as follows:

Acknowledgement and assumption of risk: I acknowledge the risks inherent in bicycling and related activities on public roads where many hazards exist, including those caused by vehicular traffic, terrain, temperature, weather, my physical condition, equipment, faulty directions and the actions or inactions of other people. I am voluntarily participating in Club activities with full knowledge of the hazards involved. I acknowledge that I am solely responsible for my personal health and safety and my personal property. I accept all risks of injury, harm, accidents, damages and losses of all types and the risk of death in connection with Club activities.
Adherence to rules. I agree to abide by all of the rules and requirements established by the Club, including the requirement to wear a helmet while bicycling. I agree to conduct myself in a safe and prudent manner while participating in Club activities.
Release of liability and covenant not to sue. I waive, release and discharge, and agree to hold harmless and not to sue, the Club or its members, board members, officers, employees, volunteers, ride leaders, participants, contractors, service providers and agents (collectively, the “Releasees”) from any and all liability, damage, losses, costs and actions of any kind (including death, disability, personal injury, property loss or damage) that may directly or indirectly relate to my participation in Club activities.
Indemnification. I agree to indemnify and hold the Releasees harmless from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities resulting from my participation in Club activities and to reimburse them for any such expenses incurred.
Medical treatment. I consent to receive medical treatment that may be considered necessary or advisable in the event of an injury, accident or illness.
Likeness. I understand and agree that I may be photographed at Club events or activities. I agree that the Club and its assigns may use my photo, video, film, voice or other likeness for any purpose, without cost to the Club.
Severability. I understand and agree that this agreement is intended to be as broad and inclusive as permitted by applicable law, and if any portion is held invalid, the balance shall continue in full legal force and effect.
Understanding; agreement to be bound. I have read and understand the terms of this agreement, and I agree to be governed by this agreement in connection with Club activities. I acknowledge that the Club is relying on this agreement in connection with such activities. I understand that I am giving up substantial rights under the agreement, including my right to sue. I am signing the agreement freely and voluntarily and intend by my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law.
Governing law. This agreement shall be governed by the law of the District of Columbia.
Scope of agreement. This agreement shall apply to all Club-related rides, events or other activities in which I participate.
Modification or amendment. This agreement may not be changed, amended or modified except in a writing signed by an authorized officer of the Club.

I understand and agree to the above waiver: *

Yes

Participants under 18 years of age must have a parent or guardian approval.

I represent that I am the parent or legal guardian of the minor whose name is set forth below (the “Minor”) and that I am acting in such capacity. I understand the hazards involved in Club-related activities, as described above, and the Minor’s experience and capabilities. I believe the Minor to be qualified to participate in such Club activities. I hereby agree to the terms of this agreement on behalf of Minor as set forth above, and I agree to indemnify, reimburse and hold the Releasees harmless from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities resulting from any defect in or lack of capacity to act on behalf of the Minor and release the Releasees on behalf of the Minor.

Name of volunteer minor:

I approve this minor's participation:

Yes

Question or Comment