Form Test - Great Plains Bicycling Club

Ride Signup (Multi Family)

Early Registration Ends on
Ride*
Rider's Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Phone*
ASSUMPTION OF RISK / RELEASE OF LIABILITY
In consideration of the GPBC providing bicycling opportunities and allowing me/us to participate in its events, I/we agree to assume the risks thereof. Further, I/we release GPBC and its officers, directors, members and agents from any and all claims for death, personal injury, or property damage which may accrue to me/us (or a minor in my care) as a result of participation in any GPBC activity or event, even though the claim may arise out of negligence or carelessness on the part of the person or entities released.
Terms and Agreement*
- Yes - I agree to the terms and conditions stated above.
Start*
- Not Specified
Finish*
- Not Specified
Registration
(Early registration fee is $30 for individual and $60 for family through August 22. Fee increases to $35 for individual and $70 for family on August 23)
Ride Registration Type*
- Individual
- Family
Please provide the names of all the family members planning to ride (we want to recognize all riders plus we need the information for food supply purchases)*
Family means parents / guardians plus minor children
This field is hidden when viewing the form
Wicking T-Shirts
(only availabe for orders through ^early^)
Pre-ordered T-shirts will be available for pickup at registration.
Some T-Shirts may be available for sale at the event.
T-Shirt - Small Quantity
Price: $33.00
T-Shirt - Medium Quantity
Price: $33.00
T-Shirt - Large Quantity
Price: $33.00
T-Shirt - XL Quantity
Price: $33.00
T-Shirt - XXL Quantity
Price: $33.00
T-Shirt - XXXL Quantity
Price: $33.00
Please Consider Joining the Great Plains Bicycle Club*
Share Phone with other Members*
Share E-Mail with other Members*
TotalCost*

Ride Signup (Multi Family)

ASSUMPTION OF RISK / RELEASE OF LIABILITY

Registration

Wicking T-Shirts

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