Wellspring Cancer Support : Register

Personal Details

First Name *

Last Name *

Alternate display name

Email Address *

Password*

Phone *

Date of birth *

.

Postal Address

Address Line 1 *

Address Line 2

City *

Postal Code *

Province *

Country *

Emergency Contact Details

Please provide us with an emergency contact

First Name *

Last Name *

Contact Number *

Relationship to you

Create a Fundraising Page

Customise your fundraising page using the options below.

Fundraising Target *

$

Add a personal image

Profile Image

Terms & Conditions

WAIVER FOR CANCERVIVE CYCLE TOUR

As part of YOUR REGISTRATION, please sign this document to acknowledge that you agree to this document, and waive certain legal rights, including the right to sue. PLEASE READ CAREFULLY!
RELEASE OF LIABILITY, WAIVER OF CLAIMS, ASSUMPTION OF RISK and INDEMNITY

In full, or partial, consideration for allowing me to participate or volunteer in all related events and activities sponsored by Cancervive Foundation of Alberta Events and Programs (the "Event") that is organized, facilitated by, and/or held at facilities owned or under lease by Cancervive Foundation of Alberta (“Cancervive”) or by Wellspring Alberta (collectively, the "Released Parties"), I hereby release the Released Parties and their respective affiliates, officers, directors, employees, servants, agents, representatives, consultants, and contractors (collectively, the "Personnel"), from, against, and in respect of, any and all claims, actions, causes of actions, damages, losses and expenses of any kind whatsoever in respect of any injury (including death), loss or damage to my person or property, or other damage or loss of any nature whatsoever that I may suffer (the "Losses"), arising out of or in connection with my attendance or participation in the Event, notwithstanding that such injuries or losses may have been caused (solely or partly) by the negligence of the Released Parties or the Personnel.

I hereby waive as against the Released Parties and the Personnel any and all claims I may now or may in the future have, and agree to hold harmless the Released Parties for any claim, arising from or related to the Losses, and I agree not to sue either the Release Parties or the Personnel in respect of same. I further agree and acknowledge that:

I have met all the prerequisites required for participation in the Event, and shall abide by the rules and regulations imposed on the participants in the Event. I have voluntarily agreed to participate in the Event, and agree that it remains my sole responsibility to conduct myself in a manner that ensures my own safety.
I have satisfied myself and believe that I am physically, emotionally and mentally able to participate in this program; and believe that my equipment is mechanically fit and appropriate for use in this Event.
I am aware of the risks inherent in the Event and knowingly, fully, and voluntarily assume such risks, both known and unknown, whether foreseeable or not, including, but not limited to, the possibility of personal injury (including death) or any other loss or damage of any nature that may result or be caused by my attendance or participation in the Event
I willingly accept the above risks and agree to the terms of this Release even if the Released Parties and/or any of their Personnel are found in law to be negligent or in breach of a duty of care or any other legal obligation to me in their conduct or omissions with respect to the Event.
I will immediately remove myself from participation, and notify the nearest official, if at any time I sense or observe any unusual hazard or unsafe condition or if I feel that I have experienced any deterioration in my physical, emotional or mental fitness for continued participation in the program
If I am injured as a result of participating in the Event, the Released Parties may secure such medical advice and services as they, in their sole discretion(s), may deem necessary for my health and safety and I shall be financially responsible for such advice and services.
This Release is binding on me, and my heirs, executors, administrators, personal representatives and assigns.
I grant the Released Parties permission to use, for promotional purposes only, any film, footage, audio tapes and/or photographs of myself, in whole or in part, taken of me while participating in the Event. I further relinquish any monetary claim against the Released Parties and agree that the film, footage, audio tapes and/or photographs may be duplicated and distributed for the educational and promotional purposes of the Released Parties.

DATED AND EFFECTIVE at the time of registration as noted on the registration confirmation.

I HAVE READ THIS FORM AND UNDERSTAND THAT BY SIGNING BELOW I WAIVE MY LEGAL RIGHT TO SUE IF I AM INJURED OR DIE WHILE PARTICIPATING IN THE CANCERVIVE CYCLE TOUR EVENT.

Personal information is collected pursuant to the Freedom of Information and Protection of Privacy Act (FOIP), Section 33, (RSA 2000) for the purposes of liability protection for The Parties. If you have any questions or concerns regarding the collection of this information during registration you may contact Wellspring Alberta, FOIPP program administrator (Executive Director).

I agree to the above Terms & Conditions *

Fundraising pledge *

I'm securing my spot in the 2025 Cancervive Ride for Wellspring on September 13, 2025 and pledge to fundraise a total of $600. I will have the full amount raised by September 13, at which time I agree to donate the difference if I have not reached the fundraising minimum.

What distance are you planning on riding? (This helps our planning, but your choice can be changed prior to the event). *

What is the longest distance bike ride you have done and when? *

What is your cycling experience level *

Are you planning to ride an e-bike? *

Would you like a T-shirt or a cycling jersey? *

What size of shirt or jersey would you like? (Note: Bike jerseys tend to fit smaller)

Gender

Age Category? *

Do you have any current or historical medical issues that would affect your ability to ride the distance you have chosen? *

Do you have any dietary restrictions we should be aware of? *

Do you have any allergies to medications, food or environmental agents? *

Joining Team Prostate Cancer Centre

Create Account