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pdf form

Application           Tour _____________  Week from_______to_______                                  

Rider’s Name____________________________________________________________

Passenger’s Name_________________________________________________________

Address_________________________________________________________________

Home Phone_____________________________Cell_____________________________

E-Mail____________________________________

T-shirt Size(s) _________________

I/we, the undersigned, hereby represent and certify that I understand what the proper operation or use of a motor vehicle, such as failure to observe and obey all traffic rules, may pose a risk of serious injury to me and others. Although I am aware of the risk incident to operating such vehicles, I am voluntary requesting the opportunity to participate in this riding event, “East Coast Motorcycle Vacation”. I desire to participate in said event of my own volition and choice, and I expressly agree to assume the entire risk of any and all accidents or personal injury while doing so. I also participate in this ride knowing that weather conditions, road conditions and other factors might affect this ride. I understand that I must wear the proper and approved required protective riding apparel while participating in this ride. Minimum requirements include a DOT- approved helmet, eye protection, a long-sleeved shirt or sturdy jacket, over the ankle footwear and long pants. I also understand that I am prohibited from operating any vehicle during this event while I am under the influence of alcohol or any other substance which might impair my ability to safely operate the vehicle. In consideration of the opportunity to participate in this event, on behalf of myself, my heirs, personal representatives successors and assigns, I give the following release and agreement not to sue: I do hereby release, agree not to sue and indemnify East Coast Motorcycle Vacation LLC, and each and all of their related companies, officers and employees, from any and all claims, demands, causes of action or liability of any kind, including any litigation expenses, lawyer fees or costs incurred for injury, damages or death which I may now or in the future have, known or unknown, or cause to happen to a third party, which in any way results from or arises out of or during the course of my participation in the aforementioned event and ride. This agreement extends to any and all claims I may have with respect to conditions, qualifications, instructions or procedures under which the event group or individual medical coverage is provided to me by virtue of my participation in this ride, and specifically acknowledge that there is no entitlement to the benefits of workman’s compensation.
I certify that I have read this release fully and understand it, and that it is a release of liability, and I am not relying on any statements or representations of any party released hereby.

Rider’s Driver’s License number & State____________________________________

Rider’s Signature_________________________________Date___________________

Passenger’s Signature______________________________Date___________________

Price includes a rental motorcycle, hotel room (double occupancy), breakfasts, maps, souvenir T-shirt, luggage van & Driver and two experienced tour guides. Tour will be booked on a first come, first-served basis. An $800 deposit will hold your spot until 60 days before departure. Deposit may be made with a credit card, but balances must be made in secured funds. If the tour is cancelled by the operator for any reason, your deposit will be refunded in full. If you cancel before 45 days from departure, your deposit will be returned in full. Cancellations after 30 days prior to departure will forfeit 50% of the amount, and after 15 days prior, will forfeit the full amount. For more info, contact
Daniel Leo, phone 508-523-5866 dleo@eastcoastmotorcyclevacation.com or
Marcello Leo at mleo@eastcoastmotorcyclevacation.com .

Deposit received: $__________________Date____________    paid in Full: $________________ Date____________

motorcycle tours east coast
Toll Free Tel. 800-518-6341
Phone: 508-523-5866
Fax: 508-807-1115
info@eastcoastmotorcyclevacation.com
www.eastcoastmotorcyclevacation.com

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