Loaner Bike Form

Middlebury College Bike Shop Loan Agreement
1. CONDITION: Bicycle lock and key must be returned in the same conditions as when issued (refer to attached condition report)
2. NO WARRANTY: The Middlebury College Bike Shop makes no warranties express or implied including the warranties of merchantability and fitness for a particular purpose.
3. HELMET: Helmets are recommended and their use is determined by the renter.
4. LIGHTS: Lights are required by state statute for night time riding and it will be the responsibility of the renter, if they choose to ride at night, to purchase a light.
5. RETURN: Bicycle, lock and key must be returned by the end of the loan period. User will be charged a Failure to return bicycle, lock and key by the date due result in $180.00 fine.


v I, the undersigned, recognize that participation in the referenced activity is strictly voluntary and that such participation does not in any manner establish an employer-employee or an agency relationship with the Sponsor orMiddleburyCollege.
v I, the undersigned, and in the event the undersigned is under 18 years of age, the undersigned's parents or guardians; in consideration of the request and permission to participate in the referenced activity hereby assume full responsibility for all risk of injury or loss which may result from my participation in the activity and hereby agree to hold harmless, release and forever discharge Middlebury College, their officers, agents, and employees from any and all claims and demands whatsoever which the undersigned or any representative of the undersigned, may have by reason of any accident, illness, injury to or death of any person or persons, or damage to or loss or destruction of any property arising or resulting directly or indirectly from participation in the aforementioned and occurring during said participation or any time subsequent thereto. The terms of this release will serve as a release and assumption of risk for my heirs, executors and administrators for all of my family members.
v I agree and acknowledge that some activities may be of a hazardous nature and /or include physical and/or strenuous exercise or activity and, understanding this,
v I state that to the best of my knowledge I have no medical, physical or mental health conditions that would hinder or prevent my active participation in the referenced activity. PLEASE NOTE: It is strongly recommended that each participant maintain some type of accident medical insurance for his/her own protection.
v I understand these are rebuilt bicycles that have undergone a fifteen point safety check and service inspection and tune up.
v I understand it is my responsibility to return the bicycle in the same mechanical condition it was in when I borrowed it. I understand I will be responsible for paying to return the bicycle to that condition and expect I will be billed for any repairs required to do so, up to maximum amount of $150.00.
v As the renter I state that I do know how to ride a bicycle and will do what I can to insure that no one else rides the bike while it is in my possession.
v I further agree to cover the cost of any lost equipment at the following rates:
Loss of lock or key $30.00
Loss of bicycle $150.00
I take responsibility for the bicycle while I have it and agree to report any problems, mechanical or otherwise, upon returning the bicycle.
 Bike Shop Contact phone for rental and repair questions 802 443-5996
To report lost or stolen bike contact the Department of Public Safety 802 443-5133

Once you have submitted the form and the request is processed, you can pick up your rental sticker at the Bike Shop at Adirondack House. Please affix them to the back of your own ID.