Participants (and their parents/guardians if a minor) are required to adhere to all of the following rules for Village Wrench programs and events, including Earn-a-Bike, 6-Cycle, or organized community service. Failure to comply with these rules will result in termination of your participation and right to an earned bicycle.

  1. Conduct: All participants are required to follow directions, to use positive words, exhibit positive actions, and to keep a positive attitude.

  2. Questionable Items: Our staff retains the right to confiscate any potentially dangerous or illegal items that may be in your possession. Disciplinary and/or legal action will be taken where necessary.

  3. Interaction: All participants are to interact with others in a friendly and respectful manner, following all rules.

  4. Assumption of Risk - Bicycle Riding: Participants understand that bicycling activities involve inherent risks, including the risk of serious injury or death. By signing this document, the participant (and parent/guardian if <18) assume those risks and any other risk incidental to Village Wrench programs. All Village Wrench bicycles that are not purchased will be earned via the 6-Cycle youth program or Earn-a-Bike.

  5. Assumption of Risk - Community Service: Earn-a-Bike participants will take part in community service opportunities, either through partner organizations or verifiable projects in the neighborhood. If picking up trash on streets, all participants are instructed and agree NOT to pick up dangerous or potentially dangerous items such as (but not limited to) broken glass, needles, nails, or anything else that could cut or injure them.

  6. Release of Responsibility: In consideration of the opportunity to participate in this program and its activities, the participant (and parent/guardian) will not hold Village Wrench, its leadership team, volunteers, employees, or other involved organizations responsible or legally liable for any injuries to the participant or property, or the results thereof, incurred and suffered as a result of the participant’s participation in any of the activities or programs.

  7. Willingness to Follow Instructions: All participants agree to use the equipment and facilities as instructed by Village Wrench’s leadership and volunteer team. The participant understands that any failure to do so on their part may prevent their participation in these activities.

  8. Fitness to Participate: The participant certifies that s/he has no physical or cognitive condition that would prohibit his/her participation in these activities. If s/he is now or has been in the past under treatment for any physical conditions that may limit participation, s/he will discuss it with the program supervisor and yield to his/her judgment as to whether s/he should participate. The participant understands that participation in these activities is entirely voluntary and that s/he may excuse him/herself from participation if so desired.

  9. Permission to Treat: The participant (and parent/guardian if a minor) give permission to Village Wrench volunteers and staff to administer routine non-emergency medical care for the participant. The participant agrees to disclose to Village Wrench and its volunteers and leadership team any medical or other conditions that would prohibit the administration of such routine non-emergency medical care.

  10. Loss Prevention: The participant’s belongings are his/her responsibility to keep track of and not lose. Village Wrench is NOT responsible or liable for anything lost or stolen. Unauthorized items will be confiscated, if a minor, and returned to participant’s parents.

Photo & Media Release

I understand that photos and videos may be taken during Village Wrench activities, and I authorize Village Wrench to use such media on or in its website, in newsletters, social media, or other forms.

Name *
Name
Date *
Date
Address *
Address
Date of Birth *
Date of Birth
Gender
Phone *
Phone
STUDENT / PARTICIPANT SIGNATURE
I have read the aforementioned rules and policies and have full understanding of the consequences for not following the rules. I understand that participating in Earn-a-Bike, 6-Cycle, or any other Village Wrench programs is a privilege that can be revoked at any time and that the rules and regulations may be changed at the discretion of Village Wrench’s leadership team.
I have read the aforementioned rules and policies and have full understanding of the consequences for not following the rules. I understand that participating in Earn-a-Bike, 6-Cycle, or any other Village Wrench programs is a privilege that can be revoked at any time and that the rules and regulations may be changed at the discretion of Village Wrench’s leadership team.
Typing your name here serves as your electronic signature.
Do you give consent for your or your child's photograph to be used?
If <18, Parent / Guardian Name
If <18, Parent / Guardian Name
As the parent or guardian of
As the parent or guardian of
I understand and consent to the rules and policies, and I take full responsibility for my student’s actions while present at Village Wrench programs or during any events. I also grant permission for my student to be present at Village Wrench and affirm the photo and media release.
I understand and consent to the rules and policies, and I take full responsibility for my student’s actions while present at Village Wrench programs or during any events. I also grant permission for my student to be present at Village Wrench and affirm the photo and media release.
Typing your name here serves as your electronic signature.
ELECTRONIC SIGNATURE CONSENT
I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Participation / Rules of Participation. *