
OCTOBER 7th 2001
SCHEDULE
OF EVENTS:
6:00-8:45 a.m. - Breakfast
7:00-8:45 a.m. - Registration
9:00 a.m.-
Ride begins
12:00 noon - BBQ Chicken (Served until all riders have
returned)
ENTRY FEES:
(including dinner and raffle
ticket)
Pre-Entry (if mailed before October 1st, 2001)
$15.00
per single Bike
$30.00 tandem
THE 1st 200 ENTRANTS WILL RECEIVE
A FREE PATCH!
Post-Entry (if mailed after October 1st or if you
register on ride date in Lompoc)
$17.00 per single bike
$34.00
tandem
Dinner ticket (non riders only)
$6.50 per person this does not
include a patch or raffle ticket)
A BENEFIT RIDE FOR LOMPOC’S HANDICAPPED
NOT A RACE! ALL ARE WELCOME!
PRE-REGISTER
EARLY AND
RECEIVE A FREE PATCH
ALL RIDERS ARE REQUIRED TO WEAR
AN APPROVED HELMET!
Each
entry form is to be used by one person only.
You may duplicate this form for
each additional applicant.
Make checks payable to:
Lompoc Elks
Bike Ride.
905 East Ocean Avenue
Lompoc,
Ca. 93436
| NAME: | _____________________________________ |
| ADDRESS: | _____________________________________ |
| CITY/STATE/ZIP: | ___________ , ____ _________-__________ |
| AGE: | ________ |
| PHONE: | (________)________-___________ |
| EMERGENCY PHONE: | (________)________-___________ |
For additional information call:
Bonnie
Braithwaite (805) 736-1835
---RELEASE OF LIABILITY—
In consideration of the acceptance of my entry in the LOMPOC ELKS JOE RYAN MEMORIAL BIKE RIDE I hereby waive, release and forever discharge any and all rights and claims for damages which I may or hereafter accrue to me against the promoters and sponsors of this event, the promoting, and organizing officials, all municipalities, special districts and properties through which this event will be held, or their respective officers agents representatives, successors and/or assigns for any and all damages which may be sustained or suffered by me in connection with said association with or entry and /or arising out of my traveling which hereafter accrue tome the promoters and sponsor of this event, promoting, and organizations, officials, all the against rules/regulations of this event. I understand that serious accidents occasionally occur during bicycle events; and those participants in bicycle events occasionally sustain serious injuries. Knowing the risks of bicycle riding on public roads nevertheless Agree to assume those risks and to release and hold harmless all the persons or entities mentioned above who through negligence or carelessness might otherwise be liable to me or my heir or assign for damages.
|
Date: |
_____/_____/_____ |
| Signature: | _______________________________________ |
|
(Signature of): |
_______________________________________ |