Muggaccinos’ Liability Acknowledgement Ride Sign-On Sheet
 

I am aware that cyclists get killed on NSW roads each year.   I am aware that Phil Johnston has no professional indemnity cover as a volunteer organiser of a dangerous recreational activity who invites members of the public to participate.   As a voluntary participant, I accept that if, at any time, I have cause to disagree with any of the obligations contained in www.muggaccinos.com – Risk Warning – Liability Acknowledgement, I will create a hardcopy of Liability Acknowledgement and amend or delete any clause(s) which I disagree with, sign the hardcopy and deliver it to Phil Johnston as Ride Organiser.

 

#

Ride Name

Ride Date

   Participant Name

On-ride
Mobile Phone No.

Contact Details

Address or e-mail

Signature

BNSW
Memb.

Exp Date

BNSW
Membership
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1

 

   /       / 17

Phil Johnston      

0434 715.861

ScribePJ@bigpond.com

 

30/06/17    

97300

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