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Volunteer Application


PRO CYCLING TOUR, LLC
353 E Lincoln Hwy
Coatesville, PA 19320
610.383.9700 Office
610.383.9502 Fax
www.procyclingtour.com
pr@procyclingtour.com

Thank you for your interest in becoming a part of the Pro Cycling Tour volunteers. Please complete and submit the following application on-line. Fields marked * are mandatory.   A photo ID must be shown at Volunteer Check-In on the day of the event(s).

Date: Sunday, May 20, 2012
* First Name:  
* Last Name:  
* Email Address:  
  Position:
  Organization:
* Mailing Address:  
* City:  
* State:
* Zip:  
* Home Phone:  
Work Phone:
Cell Phone:
* Age:  
* Sex:  
* Emergency Contact:  
* Contact's Phone:  
Comments: Please list any physical limitations and/or restrictions we should be aware of regarding your on-site participation.
Please check the race


WHAT POSITIONS INTEREST YOU?

             
Foreign Language Interpreter
*  MEN Shirt Size (Check one)
*  WOMEN Shirt Size (Check one)
IMPORTANT - READ BEFORE AGREEING
ACCIDENT WAIVER AND RELEASE FROM LIABILITY FOR VOLUNTEERS
I acknowledge that participation as a volunteer in the TD Bank Philadelphia International Cycling Championship and in related events and activities (the "Event") carries with it the potential for death, serious injury and property loss. The risks include but are not limited to those caused by terrain, facilities, temperature, lack of hydration, weather, equipment, vehicular traffic and actions and omissions of other people including coaches, officials, other participants, volunteers, sponsors, Event monitors, Event producers, police, security, municipal workers, and/or myself. These risks are inherent in the Event. I FULLY ACCEPT AND ASSUME ALL RISKS OF PARTICIPATING IN THE EVENT AND ACCEPT PERSONAL RESPONSIBILITY FOR ANY DAMAGES AND EXPENSES ARISING FROM MY PARTICIPATION.  I acknowledge that this Accident Waiver and Release from Liability will be used by and for the benefit of the following: Pro Cycling Tour LLC, TD Bank, Commonwealth of Pennsylvania, City of Philadelphia, and all other Event producers, Event sponsors, Event organizers, medical workers, volunteers, lessors and Event officials and each of their officers, directors, employees, agents, representatives, heirs, successors and assigns, and any of them (individually and collectively, “Releasees”). In consideration for my participation as a volunteer in the Event, by signing this Accident Waiver and Release from Liability below: I RELEASE AND DISCHARGE THE RELEASEES FROM ANY AND ALL LIABILITY AND WAIVE ALL CLAIMS, SUITS, AND ACTIONS OF ANY KIND AGAINST RELEASEES FOR DEATH, DISABILITY, PERSONAL INJURY, PROPERTY DAMAGE, THEFT, OR OTHER HARM THAT MAY HEREAFTER ACCRUE TO ME, MY EXECUTORS, ADMINISTRATORS, HEIRS, NEXT OF KIN, SUCCESSORS AND ASSIGNS, OR ANY OF THEM, ARISING OUT OF OR IN ANY WAY CONNECTED WITH MY PARTICIPATION IN THE EVENT.  I will indemnify and hold harmless any and all Releasees from any and all liabilities or claims made by other individuals or entities as a result of my actions or omissions during the Event. I consent to receive medical treatment which may be deemed necessary in the event of injury, accident or illness during the Event. This Accident Waiver and Release from Liability shall be construed broadly to provide a release and waiver to the maximum extent possible under applicable law. It shall not be modified in any way. If any part of this Accident Waiver and Release from Liability is determined to be invalid by law, all other parts of this Accident Waiver and Release from Liability shall remain valid and enforceable. I CERTIFY THAT I HAVE READ THIS DOCUMENT AND UNDERSTAND ITS CONTENT.

*
* PARTICIPANT'S NAME:       



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