As the RIDER designated above, I hereby certify that I:
I acknowledge and agree that it is my responsibility to wear ANSI approved and properly fitted protective head gear when participating on a CYNERGY ELECTRIC BIKES test ride or rental; and that I understand Oregon and Multnomah County Law as it pertains to bicycle helmets.
Have shown proof of my age with a photo identification; I have supplied CYNERGY ELECTRIC BIKES with a copy of my photo identification and a signed copy of this release form; I consent to the collection, retention, use and disclosure of my personal information above for identification and legal purposes and for CYNERGY ELECTRIC BIKES to make further contacts with me. This information will not be shared with other organizations except and only for the explicit purposes stated in this paragraph.
Am at least 16 years of age (18 years old for rentals); I understand that if I am under 16 years of age it is unlawful for me to ride an electric bike in Oregon and Washington State and unlawful for me to misrepresent my age.
Certify that the CYNERGY ELECTRIC BIKES representative has adequately explained to me, and I understand: the hazards, increased power and speed, and other operational details of the electric bike, including operation of the control console, gear shifting, and the braking mechanism; I will not make any adjustments to the bike during the test ride beyond the console settings and gear shifting about which the CYNERGY ELECTRIC BIKES representative has instructed me.
Certify that I am physically fit with no known physical or mental impairment and have prepared for participation on a test ride or e-bike rental; I am not under the influence of any narcotic, alcohol or other drug that may impair my understanding or judgment and that I will not at any time during the test ride or while operating the e-bike during the rental period operate the electric bike under the influence of any narcotic, alcohol or drug.
Consent to receive medical treatment, which may be deemed advisable in the unlikely event of injury, accident and or illnesses during the test ride; I agree to pay for any and all costs related to medical response, treatment and transport on my behalf.
In addition, I fully understand and acknowledge that:
(a) Risks and dangers exist in my use of any and all bicycle equipment, including CYNERGY ELECTRIC BIKES bicycles and my participation on a test ride or while riding a rental e-bike; risks and dangers may arise from foreseeable or unforeseeable causes; risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, and vehicular traffic;
(b) My participation in such activities and/or uses of such equipment can be a test of a person’s physical and mental limits, and may result in, but is not limited to, bodily injury, disease, strains, fractures, partial or total paralysis, heat stroke or other heat related injuries, heart attack, mental duress, cuts, bruises, abrasions, other injuries that could cause serious disability and death;
(c) These risks and dangers may be caused by the negligence of ofﬁcers, directors, employees, agents, and service providers of CYNERGY ELECTRIC BIKES and/or the negligence of others, accidents, breaches of contract, uncontrollable forces of nature or other causes;
(d) By my participation on a CYNERGY ELECTRIC BIKES test ride or e-bike rental and/or use of CYNERGY ELECTRIC BIKES equipment, I hereby assume all risks and dangers and all responsibility for any loss and/or damages, whether caused in whole or in part by the negligence or other conduct of ofﬁcers, directors, employees, agents, or service providers to CYNERGY ELECTRIC BIKES, or by any other entity;
(e) I am not covered by any CYNERGY ELECTRIC BIKES or other warranty or policy of insurance;
(g) I am participating on a test ride or renting an e-bike at my own risk, freely and voluntarily without any inducement or duress.
(h) For test rides, it is my obligation, unless otherwise granted through a separate agreement, to return all electric bikes I have test ridden within 20 minutes of beginning the ride. In the event that I do not return the bike within the allotted time, Cynergy E-Bikes has the right to charge and collect for the full retail price of the bike along with any accessories not returned, such as helmets, fenders (if separate from the bike), racks and seat upgrades.
(i) For e-bike rentals, I agree to all terms of the Electric Bicycle Rental Agreement when I have signed.
I, on behalf of myself, my personal and/or business representatives, next of kin and my heirs, assigns, and executors, hereby voluntarily agree to release, waive, discharge, hold harmless, defend and indemnify CYNERGY ELECTRIC BIKES and ofﬁcers, directors, employees, agents, and service providers of CYNERGY ELECTRIC BIKES from any and all claims, actions, or losses for bodily or mental injury, property damage, wrongful death or injury, loss of services, loss of income, or otherwise which may arise out of my use of CYNERGY ELECTRIC BIKES products or other equipment in connection with my participation on a test ride or e-bike rental.
Where a portion of this agreement is barred by statute or by operation of law, the remainder of the agreement shall be of full force and effect.