SALISBURY LIONS CLUB

Proudly serving Salisbury , Maryland since 1923

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REGISTRATION FOR
KNIGHTS FOR SIGHT BIKE TOUR
August 16, 2008

click here to register through active.com-http://www.active.com/event_detail.cfm?event_id=1553439
 

Registration Complete this form for each rider. This form may be copied.
Pre-registration fee includes a T-shirt, map, cue sheet, marked route, sag support, and rest stops with snacks and refreshments.

T-Shirt Size: M L XL XXL

First Name:                                                                      

Last Name:                                                                                

Street Address/PO Box:                                                                                                                   

City State Zip:                                                                                                                                    

Phone Number :                                                    

Emergency Ph. No.:                                              

e-mail (for confirmation) please write legibly
Bike Ride
–Circle one: (Mileages are approximate):
              
15 mi. 35 mi. 65 mi.

Release:
I understand that I may be injured while bicycling or otherwise participating in this event, and I agree to be responsible for my own actions. I promise to release and hold harmless the officers, volunteers and staff of the Knights for Sight bicycle tour and the Salisbury Lions Club from any claims for injury or damage resulting from my participation in this event. In case of a minor entrant, I agree to indemnify and hold harmless the above-mentioned parties from any claims for injury or damages that said minor might sustain. I promise to obey traffic laws and to practice courtesy and safety in bicycling. Helmets are required.

Signature of Registrant :                                                             
Date:                                            
Parent or Guardian of Minor (under 18):                                                                        

I enclose:$30 entrance fee: __________________Additional donation: _______________

Please make checks payable to the Salisbury Lions Club and mail to:
Peter Hutchinson
611 Twin Tree Road
Salisbury, MD 21801-6721