JUMPSTART™ Demo Release and Consent Form

THIS IS A RELEASE, PLEASE READ BEFORE SIGNING

I hereby represent, warrant, and certify that the above information is true and correct. I, the undersigned, am being given the opportunity to ride and operate one or more running Harley-Davidson® motorcycles attached to a dynamometer (the “JUMPSTART™ activity”). I recognize and understand that Harley-Davidson Canada LP (“Harley-Davidson Canada”), its subsidiaries and affiliates, the dealer or location named above, and any other organizers, sponsors, officials, and volunteers, and their respective directors, officers, shareholders, employees, partners, affiliates, agents, representatives, successors, and assigns (all being collectively referred to hereafter as “Released Parties”) are relying upon the accuracy of the information that I am supplying above in allowing me the opportunity to participate in the JUMPSTART™ activity.

I acknowledge that participating in the JUMPSTART™ activity involves certain risks and dangers both known and unknown.  These risks and dangers may expose me to personal injury or death, which may be caused or contributed to by the negligence or carelessness of others.

For and in consideration of this opportunity to participate in the JUMPSTART™ activity, I (on my own behalf and on behalf of my heirs, executors, administrators, legal representatives and assigns) assume and accept, without limitation, all risks and dangers associated with my participation in this activity.  I assume full responsibility for understanding and following the rules and safe practices associated with participating in this activity and for my personal safety, and hereby irrevocably release and forever discharge the Released Parties from any and all claims, demands, rights, and causes of action of any kind whatsoever, howsoever arising, directly or indirectly, which I now have, or later may have, whether known or unknown, in any way resulting from, in respect of or arising in any way out of the JUMPSTART™ activity.

Without limiting the foregoing, this Release extends to any and all claims, which I have or may have against any or all of the Released Parties, whether such claims result from strict liability or negligence on the part of any or all of the Released Parties or from any action or inaction on my part, including, without limitation, any claims relating in any way to the design, manufacture, repair or maintenance of the Harley-Davidson® motorcycle(s), which I operate during the JUMPSTART™ activity, or with respect to the conditions, qualifications, instructions, rules, or procedures under which the JUMPSTART™ activity is conducted, or from any other cause.

For and in consideration of my being allowed to participate in the JUMPSTART™ activity, I agree to indemnify and hold harmless the Released Parties from any and all liability, claims, causes of action, demands, damages, or any other forms of relief which might be made against any or all of the Released Parties whatsoever, howsoever arising, directly or indirectly out of or in consequence of my participation in the JUMPSTART™ activity. I agree that this Release and Consent may be treated as a complete defence to any action or proceeding that may be brought against the Released Parties and shall forever be a complete bar to the commencement or prosecution of any action or proceeding which is within the scope of this Release.

BY SIGNING THIS RELEASE, I CERTIFY THAT I HAVE READ THIS RELEASE AND FULLY UNDERSTAND IT AND THAT I AM NOT RELYING ON ANY STATEMENTS OR REPRESENTATIONS OF ANYONE RELEASED THEREBY.

CONSENT TO COLLECTION, TRANSFER AND USE PERSONAL INFORMATION

I agree that Harley-Davidson Canada, the dealer and their vendors and affiliates (collectively the “Users”), may collect and use my personal information for the purposes of administering my participation in the JUMPSTART™ activity. I further agree that the Users may also use my personal information to better understand their customers and improve their products and services, and for other purposes with my consent or as permitted or required by law. I acknowledge that the file containing my personal information will be maintained at the Users’ premises and that authorized employees and representatives of the Users will have access to my information as necessary to perform their job functions. I understand that the file may be transferred by the Users (or vendors retained by the Users) to locations outside of Canada, where the file may be subject to the jurisdiction of foreign governments. I understand that I may request access to or correction of my personal information in the custody or control of the Users, or ask any questions (including those with respect to the Users’ use of service providers outside of Canada) by contacting the Privacy Officer at DataPrivacy@harley-davidson.com or Harley-Davidson Customer Care at 1-800-258-2464.

  CONSENT TO RECEIPT OF COMMERCIAL ELECTRONIC MESSAGES

By checking “Yes” below, I agree to receive communications, including electronic communications, from Harley Davidson Canada, Harley Owners Group (H.O.G.), the dealer, and other authorized Canadian Harley-Davidson® dealers regarding Harley-Davidson® Brand products, services, programs, contests, and promotional offers, and for market research purposes.  Harley-Davidson Canada is seeking such consent on behalf of itself, its affiliates, the dealer, H.O.G., and other authorized Canadian Harley-Davidson® dealers. I understand that I may withdraw my consent at any time from Harley-Davidson Canada and H.O.G. by contacting the Privacy Officer at DataPrivacy@harley-davidson.com or Harley-Davidson Customer Care at 1-800-258-2464, or from the dealer by contacting the dealer at the address and phone number provided above.