SAFETY COURSE -- GENERAL RELEASE, WAIVER & INDEMNIFICATION AGREEMENT rev. 03/20
In consideration for ________________________, the State of New York, its Motorcycle Safety Program and Department of
Motor Vehicles, the Motorcycle Safety Foundation, Inc. (“MSF”), the training sponsor, the owner of the training motorcycle and
premises upon which training occurs, including each of their affiliates, subsidiaries, members, employees, officers, coaches,
instructors, aides, and/or agents (the “Released Parties”), furnishing services, equipment, and/or curriculum and permitting the
undersigned to participate in this Motorcycle Safety Course (the “Course”), the undersigned Participant agrees to all of the
following:
Participation in the Course requires physical stamina, motor coordination, and mental alertness. I hereby attest that I have no
known physical or mental limitations and have not used any form of alcohol, or prescription or non-prescription drugs that could
impair my performance in the Course. Participants under 18 years of age must have this form signed by a parent or guardian IN
PERSON at the training location, or this form must be NOTARIZED.
I fully understand and acknowledge that (a) this Agreement is intended to be as broad and inclusive as permitted by the laws of
the State in which the Course is conducted; (b) if any portion of this Agreement is for any reason held invalid or legally
unenforceable, then the balance shall, notwithstanding, continue in full force and legal effect; and (c) I have had the opportunity
to ask any questions about this Agreement and I fully understand its terms and meaning.
READ CAREFULLY: THIS IS A GENERAL RELEASE, WAIVER, ASSUMPTION OF RISK & COVENANT NOT TO SUE
I fully understand and agree that: (a) there are DANGERS AND RISKS OF INJURY, DAMAGE, OR DEATH that exist in my
participation in the Course and use of motorcycles and motorcycling equipment (“Motorcycling Activities”); (b) my participation in
the Course and Motorcycling Activities may result in injury or illness including, but not limited to, BODILY INJURY, DISEASE,
STRAINS, FRACTURES, PARTIAL OR TOTAL PARALYSIS, OTHER AILMENTS THAT COULD CAUSE SERIOUS
DISABILITY, AND DEATH; (c) these risks and dangers may be caused by negligence of Released Parties, other Course
participants, or others, and may arise from foreseeable or unforeseeable causes; and (d) by participating in the Course and
Motorcycling Activities, I, on behalf of myself, my personal representatives and my heirs, hereby knowingly and
voluntarily assume all risks and all responsibility, and agree to release the Released Parties for any injuries, losses
and/or damages, including those caused solely or in part by negligence of the Released Parties or any other person. If I have
brought a motorcycle or helmet to use in the Course, this Agreement applies to any damage that occurs to or from my
motorcycle or helmet during the Course.
I fully understand and agree that, on behalf of myself, my personal representatives and my heirs, I hereby covenant not to sue, and
am relinquishing any and all rights I now have or may have in the future to sue the Released Parties for any and all injury, damage,
or death, whether known or unknown, that I may suffer arising from the Course, or from motorcycle riding or its equipment,
including claims based on the Released Parties’ negligence.
I HAVE READ THIS AGREEMENT AND BY SIGNING BELOW I AGREE TO THE ABOVE TERMS, AND TO ASSUME ALL
RISKS AND RELEASE THE ABOVE-NAMED RELEASED PARTIES FROM LIABILITY FOR PERSONAL INJURY,
PROPERTY DAMAGE OR WRONGFUL DEATH CAUSED BY NEGLIGENCE OR ANY OTHER CAUSE.
____________________________________________ _____________________ ______________________________________
Participant Name (Printed) – First, Middle, Last License or ID# and State Participant Signature
__________________ _____________________________________________________ ___________________ ________________________
Date – MM/DD/YYYY Parent/Legal Guardian signature, if Participant under 18 yrs of age Relationship License or ID# and State
READ CAREFULLY: THIS IS AN INDEMNIFICATION AND HOLD HARMLESS AGREEMENT
I, on behalf of myself, my personal representatives and my heirs, agree to hold harmless, defend, and indemnify the Released
Parties from any and all claims, suits, or causes of action by any third parties, including Released Parties or other Course
participants, for bodily injury, property damage, or other damages that may arise out of my use of motorcycles and motorcycle
equipment or my participation in the Course, including claims arising from the negligence of Released Parties, other Course
participants, or any other party.
I HAVE READ THIS AGREEMENT AND BY SIGNING BELOW I AGREE TO THE ABOVE TERMS, AND TO ACCEPT LEGAL
RESPONSIBILITY AND PAY FOR ANY LOSS FOR CLAIMS OR LAWSUITS AGAINST THE ABOVE-NAMED RELEASED
PARTIES ARISING FROM MY PARTICIPATION IN THE COURSE.
____________________________________________ _____________________ ______________________________________
Participant Name (Printed) – First, Middle, Last License or ID# and State Participant Signature
__________________ _____________________________________________________ ___________________ ________________________
Date – MM/DD/YYYY Parent/Legal Guardian signature, if Participant under 18 yrs of age Relationship License or ID# and State
White – MSF Copy Yellow – RERP Sponsor Copy Pink – Student Copy
