SUNNYVALE-CUPERTINO CYCLING CLUB

The SUNNYVALE-CUPERTINO CYCLING CLUB (SCCC) is a group of cyclists whose goal to provide an organization to support and develop cyclists. The SCCC e-mail news group lists up coming events, rides and club announcements. Dues are $85.00 per calendar year per individual and includes a jersey.

<<<<RELEASE OF LIABILITY AGREEMENT>>>>
(Please print and fill out form)

(EACH APPLICANT FOR MEMBERSHIP SHALL READ AND SIGN THE FOLLOWING RELEASE AGREEMENT).

Upon acceptance of my membership to the SUNNYVALE-CUPERTINO CYCLING CLUB (SCCC)
and being permitted to participate in any club event sanctioned, sponsored or organized by the SCCC, I hereby, for myself, my heirs, executors, successors, administrators and assigns, release, waive and discharge any and all claims for liability and damages resulting in death, personal injury or damage to any and all property which may occur, or which may later become accountable to me as a result, directly or indirectly of my participation in SCCC events. I further understand this release is intended to discharge and release in advance, the SCCC, it's members and their respective agents, officers, officials, servants, employees and representatives from and against any and all liability arising out of or connected in any manner with my participation in any club sponsored events or activities,

EVEN WHEN SUCH LIABILITY ARISES OUT OF NEGLIGENCE OR CARELESSNESS ON THE PART OF SCCC, ITS MEMBERS, OFFICERS, AND REPRESENTATIVES.

Print name: _________________________________ age > 18 yes / no

SIGNATURE OF APPLICANT: _________________________________ DATE: ___________

(IF UNDER AGE 18, SIGNATURE OF PARENT OR GUARDIAN IS REQUIRED) ______________________________________

<<<< MEMBERSHIP APPLICATION >>>>

Enclosed is the fee of eighty five dollars ($85.00) for individual membership, which entitles me to all the rights and privileges of club membership. (make check payable to the Sunnyvale-Cupertino Cycling Club).

(Please print) Name:___________________________________ Email Address:_____________________________________

Address:__________________________________________________________________________________________

Telephone: Day: ____________________Eve: ____________________Cell: ____________________

( ) Renewal Membership

( ) New Membership (please give Previous Club name) ____________________________

Race Category (if applicable)__________________

Mail to: SCCC Membership
c/o Scott Swail
1157 Bennington Dr
Sunnyvale, CA 94087