2008 Blackhawk Country Roads Registration/Release
(Please print)
Name ___________________________________________________________
Street ____________________________________________________________
City _________________________________ State ________ Zip __________
Phone ___________________ Bike Club Affiliation _______________________
Ride Fee $_____
T-shirt Fee $_____ Adult Sizes S M L XL Total Paid $______
Mail to: Blackhawk Bicycle and Ski Club
Attn: Blackhawk Country Roads
-----------------------------Register---------------------------
before Apr 25 before May 16 after May 16
Individual rider w/T-shirt________$22____________$29____________$34
Individual rider no T-shirt ______________________$16____________$21
Family of 3 no T-shirt _________________________$36____________$41
Additional T-shirt_____________________________$13
Additional riders under 18_______________________$6_____________$8
Additional day ride fee $10
Release of organizers and sponsors:
In signing this form for myself or the above named participant (if he or she is under 18), I understand and agree to absolve all of the sponsors and organizers, be they individuals or organizers, singularly and collectively, of all blame for any injury, misadventure, harm, loss or inconvenience suffered as a result of taking part in this event or in any of the activities associated with said event.
Signature ________________________________________ Date ________________
rev 09 March 2008