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Glow Ride 2015 Pre-RegistRATION
Registration will be required of all Glow Ride 2015 riders. Pre-registration by 11:30pm Monday, July 27th gets you a mini swag pack!
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Name
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First
Last
Email
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Phone Number
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Emergency Contact & Phone Number
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I acknowledge that the Glow Ride is an event that may test a person’s physical and mental limits and carries with it the potential for death, serious injury and property loss. The risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of trails or roads, condition of participants, equipment, vehicular traffic, actions of other people, and lack of hydration. I hereby assume all of the risks of participating in this event and understand that I am responsible for acting in a way that ensures my safety.
I agree to obey all traffic laws of the hosting state and understand that is strongly recommend that I wear an approved helmet while cycling in this event. I certify that I am physically fit at a level I can meet the physical and mental demands of this event. I acknowledge that this Accident Waiver and Release of Liability form will be used by River Benders Cycling Group, and that it will govern my actions and responsibilities at said events.
In consideration of my application and permitting me to participate in this Event, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors and assigns as follows: A) Waive, Release, and Discharge from any and all liability for my death, disability, personal injury, property damage, property theft or actions of any kind which may hereafter accrue to me including my traveling to and from this event, THE FOLLOWING ENTITIES OR PERSONS: River Benders Cycling Group, its organizers, and all state, county, and municipal agencies responsible for maintenance of the trails and roadways upon the Event itinerary (hereafter referred to as Releasees); and (B) Indemnify and Hold Harmless the entities and persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this Event, whether caused by the negligence of Releasees or otherwise.
I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident and/or illness during this Event.
The Accident Waiver and Release of liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.
I understand that at this event or related activities, I may be photographed. I agree to allow my photo, video or film likeness to be used by River Benders Cycling Group for group marketing purposes.
I HAVE READ THIS RELEASE AND UNDERSTAND ITS CONTENT.
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Yes
Complete Registration
NOTE: You must complete ticket information at the "Complete Registration" link above for your pre-registration to be processed.