TOUR ENTRY FORM (photocopies accepted
Name_____________________________________Address_________________________________
City_________________________________________________State________Zip______________
Phone ( )____________________________Male____Female______Age______(as
of Aug.16th,2008)
____12 mile______22 mile
T-shirt
size
__________
____38 mile______62 mile
Registration
Fee $20.00 for early-birds,$25.00 after 1st Aug.2008
___________
Please select one
of the above
Mighty Kids ride-
Kids 8 & under. ___Free_____
.Note: This event
will be held regardless of
Kids
14 & under receive a $5.00 discount: ___________
weather.
Registration fee is non-refundable
Extra T-shirts:
$10.00 ea. (? Size_______):_____________
Total Amount
Enclosed :___________
Waiver: In
consideration of the acceptance of this entry. I the undersigned assume all
risks and full and complete responsibility for any injury or accident which
may occur during my participation in any of the Vernon Burnin Bike
Ride events., or while I am on the premises of the event, and I hereby release
and hold harmless the sponsors, Promoters, and all other persons and entities
associated with the event from any and all injury or damage and liability. I
acknowledge that I am familiar with the dangers involved in participating in
such an event and that there may be defects in the riding surface or other
permanent or temporary obstacles which I must be careful to avoid. I also
recognize there may be vehicular traffic along the course. I understand that a
bicycle is a legal vehicle in the State of
(Signature of parent or guardian if under the age of 18)
Send
Complete Form To: