Beaverton, Banks and Beyond Ride Registration

First Name:

Last Name:

Email:

Phone:

Address:

City:

State:
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Zip:

Meal Choice
One slice of pizza (plain or pepperoni), salad, cookie, and a choice of bottled water or soda
Sandwich, chips, cookie, and a choice of bottled water or soda

Minor
This registration is for a minor

Waiver and Release
In consideration of my entry in Beaverton, Banks, and Beyond, I, for myself, my heirs, executors, administrators and assigns, waive, release, and discharge any and all rights, claims, or damages against NW Bicycle Safety Council and all participating sponsors and directors, volunteers, employees or agents of such, for all claims, demands, actions, or causes incident to my event participation at the forthcoming ride. I attest and verify that I have full knowledge of the risks involved in this event, that I assume those risks; that I will assume and pay my own medical and emergency expenses in the event of an accident, illness, or other incapacity; that I am physically fit and sufficiently trained to participate in this event; that my donation is nonrefundable, and that I have read and understand this waiver is a total and complete release to NW Bicycle Safety Council for any and all damages or injuries that I might incur as a participant. Entries cannot be accepted without a valid signature. Entries from minors will only be accepted with a parent or legal guardian’s signature.