Minor Rider Registration (Parent/Guardian)

Minor rider supervision requirement (all routes)
A minor may participate only if their own parent or legal guardian rides WITH them on the SAME route for the ENTIRE ride, from start to finish. No drop-offs or unaccompanied riders. The accompanying parent or guardian must also complete their own separate adult rider registration at https://form.jotform.com/263126097623054.
Please choose the same 5-mile or 15-mile ride on both registrations.

A copy of the official registration and financial information may be obtained from the division of consumer services by calling toll-free within the state, 1-800-HELP-FLA. Registration does not imply endorsement, approval, or recommendation by the state. Serene Harbor, Inc.’s registration number is CH3352.

A properly fitted bicycle helmet is REQUIRED for every rider, including minors. Front and rear bicycle lights are STRONGLY RECOMMENDED for all riders, even during daylight hours, because our routes use shared public roadways. Parents or legal guardians are responsible for ensuring their minor rider has appropriate safety equipment.

PEDALS WITH PURPOSE MINOR PARTICIPANT LIABILITY WAIVER & PARENTAL CONSENT
Event Date: December 5, 2026
Location: Cocoa Riverfront Park, Cocoa, Florida

Event Organizers: Coast2Coast Mortgage LLC, doing business as Shorepoint Mortgage, and Clear Title Organization LLC.

1. PARENTAL CONSENT
I certify that I am the parent or legally authorized guardian of the minor participant identified in this registration and have the legal authority to authorize their participation in Pedals With Purpose on December 5, 2026.

I voluntarily grant permission for my child to participate in either the 5-mile Fun Ride or 15-mile Challenge Ride.

2. ACKNOWLEDGMENT OF RISK
I understand that bicycling involves inherent risks, including collisions with vehicles, pedestrians, other cyclists, or objects; falls; roadway hazards; mechanical failures; weather conditions; dehydration; physical exhaustion; serious injury; permanent disability; or death.

I understand these risks may exist even when reasonable safety precautions are followed.

I knowingly acknowledge and assume the inherent risks associated with my child's participation.

3. RELEASE OF LIABILITY
To the fullest extent permitted by Florida law, and subject to Florida Statute § 744.301, I agree on behalf of my minor child to release Coast2Coast Mortgage LLC d/b/a Shorepoint Mortgage, Clear Title Organization LLC, and their respective owners, officers, employees, agents, and authorized event volunteers from claims arising from inherent risks of the event that may lawfully be released in advance.

This agreement does not waive claims that cannot legally be released under Florida law Florida Statute § 744.301(3)(b).

4. MANDATORY PARENTAL SUPERVISION
I understand and agree that all riders under 18 must be accompanied by their own parent or legal guardian throughout the entire bicycle ride.

I agree that:

I will personally accompany my child on the selected route.
My child and I will ride the same 5-mile or 15-mile route.
I will remain with my child from the beginning of the ride until its completion.
My child will not be dropped off or permitted to ride independently.
I will complete my own separate adult rider registration and waiver.
I remain responsible for supervising my child throughout the event.
I understand that event organizers and volunteers do not provide individual childcare or supervision.

5. SAFETY REQUIREMENTS
I agree to ensure that my child wears a properly fitted bicycle helmet, uses a bicycle appropriate for their size and abilities, follows applicable traffic laws and event instructions, and rides within their physical capabilities.

I understand that event organizers may deny or discontinue participation when safety requirements are not followed.

6. MEDICAL AUTHORIZATION
If my child becomes injured or requires emergency medical assistance, I authorize event personnel to contact emergency medical services and authorize medical personnel to provide care as permitted by applicable law.

I understand that I am financially responsible for any resulting medical expenses.

7. EVENT CONDITIONS
I understand that routes, schedules, or activities may be modified, postponed, or canceled because of weather, road conditions, or other safety concerns.

I understand that event organizers cannot guarantee the condition of roads, paths, or riding surfaces.

8. PARENT OR GUARDIAN ACKNOWLEDGMENT
By signing this agreement, I acknowledge that:

I am the minor participant's parent or legally authorized guardian.
I have read and understand this agreement.
I understand the risks associated with recreational cycling.
I authorize my child's participation.
I agree to accompany and supervise my child for the entire ride.
I understand this agreement may affect important legal rights.
I voluntarily agree to its terms.