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Cycle Kingston Scavenger Hunt Registration Form

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					              Cycle Kingston Summer Scavenger Hunt Registration Form
                   Email completed forms to: eturn102@uottawa.ca
Name: _______________________________________________________
Address: _____________________________________________________
Email: _______________________________________________________
Phone: _______________________________________________________
                           *Winners will be contacted by phone/email*


Are you a Member of Cycle Kingston?

    Yes
    No
    No, I would like more information about becoming a member

Registration Fee is by donation. Donations go towards the Cycle Kingston cycling
education fund. (Donations over $10.00 are eligible for a tax receipt).

    Donation of $__________
    No donation at this time, thank-you

How did you hear about the Cycle Kingston Summer Scavenger Hunt?

      Poster
      Open House
      Website
      Other ___________________

Would you be interested in being contacted to volunteer at other events throughout the
season?

    Yes
    No thank-you

Date: _____________________________ Signature: ________________________________
*Please read and sign the liability waiver found on the reverse side of this form.*
                     Thank-you and good luck in the scavenger hunt!!
      RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT
                           PLEASE READ CAREFULLY

This is a binding legal agreement. As a Participant in the programs, activities and events of Cycle Kingston, Inc., the
undersigned acknowledges and agrees to the following terms.

Disclaimer: Cycle Kingston, their directors, officers, members, leaders, instructors, volunteers, officials,
participants, agents, sponsors, owners/operators of the land or facility where programs, activities and events occur,
and representatives are not responsible for any injury, death, loss, expense or damage of any kind suffered by a
Participant during, or as a result of, any program, activity or event, caused in any manner whatsoever including, but
not limited to, the negligence of Cycle Kingston.

Description of Risks: I FULLY UNDERSTAND that: (a) cycling is an inherently dangerous activity in which I
participate at my own risk; (b) cycling involves risks and dangers of property damage, illness, serious bodily injury,
including permanent disability, paralysis, and death, (c) these risks and dangers may be caused by my own actions or
inactions, the actions or inactions of others participating, the NEGLIGENCE ON THE PART OF CYCLE
KINGSTON INCLUDING THE FAILURE ON THE PART OF CYCLE KINGSTON TO SAFEGUARD OR
PROTECT ME FROM THE RISKS, DANGERS AND HAZARDS OF CYCLING, or the condition in which
cycling takes place.

The risks associated with the cycling include, by way of example and not limitation, the following: collisions with
other cyclists, pedestrians, vehicles, fixed or moving objects; falls; loss of balance, difficulty or inability to control
one’s speed and direction, becoming lost or separated from the leaders or other participants; equipment failures and
malfunctions; failure to negotiate obstacles and hazards, both marked and unmarked, including railway tracks, ruts,
holes, potholes, rocks, stones, sand, gravel, mud, water, oil and/or other objects on the ground or in the roadway;
variations or steepness in terrain; varying visibility (including riding at night for evening events); fatigue;
exhaustion; dehydration; heatstroke; hypothermia; changing weather conditions, encounters with wild or other
animals. I understand the description of these risks is not complete and that unknown or unanticipated risks may
result in property damage, illness injury, or death.

I AM AWARE OF THE RISKS, DANGERS AND HAZARDS ASSOCIATED WITH CYCLING AND I FREELY
ACCEPT AND FULLY ASSUME ALL SUCH RISKS, DANGERS AND HAZARDS AND THE POSSIBILITY
OF PERSONAL INJURY, DEATH, PROPERTY DAMAGE AND LOSS RESULTING THERE FROM.

Release of Liability and Acceptance of Terms
In consideration of Cycle Kingston allowing me to be a Participant, I agree:

1. To assume all risks arising out of, associated with or related to my participation;
2. To be solely responsible for any injury, death, loss, expense or damage that I might sustain while participating;
3. To release Cycle Kingston (including all directors, officers, members and volunteers) from liability for any and all
claims, demands, actions and costs that might arise out of my participating, even though such risks, injuries, loss,
damage, claims, demands, actions or costs may have been caused by the negligence of Cycle Kingston;
4. To follow all laws associated with the Ontario Highway Traffic Act and bicycle use.

Acknowledgement: I acknowledge that I have read this agreement, that I have executed this agreement voluntarily,
and that this agreement is to be binding upon myself, my heirs, executors, administrators and representatives.

Signature: ______________________________________
                   Cycle Kingston Summer Scavenger Hunt Event Details

Each activity in the Scavenger Hunt earns you points. Complete all the activities in a section to
get bonus points! Activities marked with a * are required for a chance to be the winner. At the
end of the scavenger hunt, the top three participants will be declared the winners and will be
contacted by July 31, 2011.

Tuesday, July 26 1:00pm-2:00pm, 7:00pm-8:00pm (303 York Street, Room 121)

*Scavenger Hunt Training Session: Learn tips and techniques to help you conquer the Scavenger
Hunt. You must complete all four items. Ask an ambassador to check off each box on your
participant form as you complete the item. You will receive 1 point for each item, and 1 bonus
point upon completion of all four.

Wednesday, July 27 10:00am-11:00am, 2:00pm-3:00pm, 6:00pm-7:00pm (Downtown Kingston)

Spot a Cycling Ambassador: Find a Cycling Ambassador out on a daily ride wearing their bright
yellow Cycling Ambassador jersey. 5 points for each time you see them, 25 points if you see
them all three times. Ask an Ambassador to check of each box on your participant form as you
see them.

Thursday, July 28 (addresses listed below)

Visit to local businesses: Visit the local businesses listed below where you will be a question to
answer. Answer the question in the space provided on your participant form. If you do not know
the answer to the question, ask a staff member for assistance. You will receive 5 points for each
business you visit, and a 10 point bonus if you visit every business on the list.

The Mug and Truffle, 350 King Street East
Novel Ideas, 156 Princess Street
Pan Chancho, 44 Princess Street
Service Canada, 182 Sydenham Street
Tara’s Natural Foods, 81 Princess Street

Friday, July 29 (addresses listed below)

Visit to local bicycle shops: Visit the local bicycle shops listed below where you will be given a
question to answer. Answer the question in the space provided below. If you do not know the
answer to the question, ask a staff member for assistance. You will receive 5 points for each
business you visit, and a 10 point bonus if you visit every business on the list.

The Cyclepath, 471 Princess Street
Frontenac Cycle and Sport, 336 Barrie Street
Gears and Grinds, 42 Queen Street

Friday, July 29 7:00pm-8:00pm (303 York Street, room 121)

*Participant Form Submission: Submit your completed participant form in person to the Cycle
Kingston office. Light refreshments will be served. Winners will be notified by Sunday, July 31.
                  Cycle Kingston Summer Scavenger Hunt Participant Form

Check off completed items here. Items marked with a * are required for a chance to be the
winner. Good luck and have fun! Roll on!

Tuesday, July 26 1:00pm-2:00pm, 7:00pm-8:00pm

*Scavenger Hunt Training Session: You must complete the following items:

      helmet fit check (1 point)
      bicycle check (1 point)
      hand signal review (1 point)
      road safety (1 point)        (1 bonus point when you complete all 4)

Wednesday, July 27 10:00am-11:00am, 2:00pm-3:00pm, 6:00pm-7:00pm

Spot a Cycling Ambassador:
    10:00-11:00 (5 points)
    2:00-3:00 (5 points)
    6:00-7:00 (5 points)            (10 bonus points if you complete all 3)

Thursday, July 28

Business                    Answer:
The Mug and Truffle                                                                        5pnts
Novel Ideas                                                                                5pnts
Pan Chancho                                                                                5pnts
Service Canada                                                                             5pnts
Tara’s Natural Foods                                                                       5pnts
* 10 bonus points if you complete all stops*

Friday, July 29

Cycle Shop                  Answer:
The Cycle Path                                                                         5pnts
Frontenac Cycle and Sport                                                              5pnts
Gears and Grinds                                                                       5pnts
* 10 bonus points if you complete all stops*

				
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