11th Annual Fathers Day Bike Ride
June 21st, 2015
 

  
   
Participant Information
 
 
Family Name*
 
 
Name of all Paricipants*
 
 
 
 
Contact Information
 
 
Address: Street 1*
 
 
State*
 
 
City*
 
 
Zip/Postal Code*
 
 
Email*
 
 
Phone Number*
 
 
 
How did you hear about the ride?
 
 
Add me to the following mailing lists:
The Eli's Cheesecake Company Mailing
 
 
 
 
Wright College Mailing
 
 
 
 
Rudy's Cycle & Fitness Mailing
 
 
 
 
 
 
 

Waiver and Release
For Participant in the Eli's Cheesecake 11th Annual Father's Day Ride of June 21st

I, the undersigned, herby for myself, my heirs, executors and administrators, waive and release any and all rights and claims I may have against The Eli’s Cheesecake Company, Rudy’s Cycle & Fitness, The Chicagoland Bicycle Federation, Wright College, the City of Chicago, and all other sponsors, their representatives, successors, and assigns, for any and all injuries suffered by me in this event, including pre- and post- ride activities.

I attest and verify that I have full knowledge of the risks involved in this event, and that I am physically fit and have sufficiently trained to participate.  I grant full permission to use photos and/or statistics of this event.

 
First Name*
 
 
Last Name*
 
 
Date*
 
 
By checking this box, you are agreeing to our terms and conditions*