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Mail Entry To
Operation Red Sleigh
PARTICIPANT INFORMATION
(circle one) SELECT COURSE: 20K 50k 100K
FIRST/LAST NAME: ___________________________________
SIGNATURE: _________________________________________ ADDRESS: ____________________________________________
SEX: (circle one) MALE FEMALE AGE: ______ BIRTHDATE ____________ CITY/STATE/ZIP ______________________ Email: ____________________________ HOME PHONE: ____________________ SELECT SHIRT SIZE: (circle one) S M L XL XXL
EMERGENCY CONTACT: _______________________________
EMERGENCY PHONE: __________________________________ PLEASE ENCLOSE A CHECK OR MONEY ORDER IN THE CORRECT AMOUNT WITH YOUR
REGISTRATION FORM (Make checks payable to Operation Red Sleigh.) I ACKKNOWLEDGE THAT
MY REGISTRATION FEE & ANY DONATIONS THAT I MAY RAISE WILL NOT BE REFUNDED IF
I CHOOSE NOT TO PARTICIPATE IN THE EVENT. PLEASE SIGN THE WAIVER ON THIS REGISTRATION FORM.
LIABILITY RELEASE AND WAIVER
For and in consideration of the right to participate in the Operation Red Sleigh Charity Bike Ride
July 19, 2008 event, the undersigned does hereby releases, Absolve and hold harmless the
Randolph Co. Law Enforcement and the Seagrove Elementary School, their sponsors, heirs,
successors, assigns, volunteers, agents, and Personnel from any and all actions, cause of action,
liability or responsibility whatsoever, or any injury, harm, loss or inconvenience suffered or incurred by
the Undersigned during or as a result of taking part in the Operation Red Sleigh Charity Bike Ride.
The undersigned further understands that obedience of traffic regulations and signal devices are
his or her own responsibility. The undersigned understands and agrees that the sponsors
make no warranties, whatsoever and are not responsible for one?s safety during or while
traveling to and from the Operation Red Sleigh Charity Bike Ride.
I, the undersigned, have fully read, understand and agree to all terms contained herein and so signify by signing and dating below.
SIGNED: ________________________________________________
Date: ____________________________________
If the applicant is under 18 years of age, a parent or guardian must read and agree to the above conditions and is consenting to entrants participation. If agreeable, he or she must sign and date above. Online Registration click here http://www.active.com/event_detail.cfm?event_id=1596988
Send to: Operation Red Sleigh Bike Ride
7158 Canaan Ch Rd
Denton, NC 27239 |
