Appalachian Bike Tour Scholarship Ride
24th Annual 2017 Appalachian Bike Tour Scholarship
Designed By Allen Kelly © All Rights Reserved 1999 - 2017  |   Last Updated: March 2, 2017 |  E-mail: Donna Childers
The 2017 Appalachian Bike Tour Scholarship Ride will be September 23, 2017
Yatesville Lake Marina Shelterhouse Louisa, Kentucky Bike Tour will be held on September 23, 2017 Rain or Shine Registration Time at 8:00AM Ride Starting Time at 9:00AM
Name:_______________________________________________________________                                          Address:_____________________________________________________________                         City:_____________________  State:__________  Zip Code:__________________ Telephone Number: (        )               -                        Emergency Contact:_______________________  Age: (If under age 18.) ___________ T-Shirts will be sold at the marina.                                      Return to:                                 Kerry Wheeler                                 2612 HWY 1760                                                      Louisa, Kentucky  41230                                                      (606)-652-3681
WAIVER
Helmets are REQUIRED.   I understand that the Appalachian Bike Tour requires bicycle helmets to be worn by all participates while operating bicycles and that there is no exception to this requirement.  I agree to wear a bicycle helmet at all times during this event when I am operating a bicycle.  I am aware of the risks of bicycling and otherwise participating in this event and voluntarily assume such risks.  In consideration of being permitted to participate in this event: (1.) I release for myself, my heirs and personal representatives and the undersigned registrant under the age of 18 (minor)___________________________, Lawrence County Democratic Woman's Club and their respective directors, officers, volunteers and staff ("indemnities") from any claim, liability, demand, action, and cause of action whatsoever (collectively claim) arising out of or related to any loss, damage, or injury (collectively "loss"), to myself or my property, that I may sustain in connection with or arising out of this event; (2.) If registered as a minor, I (as a parent or guardian) agree to indemnify and hold harmless each indemnitee against any claim for any loss said minor may sustain in connection with defending any claim by or on behalf of said minor for any loss. (3.) Consent to emergency medical treatment if I  am injured (4.) Shall obey the traffic laws and practice safety in bicycling and (5.) Agree to wear an  CPSC or Snell approved helmet on all bicycling riding on this event.  If no signature or guardian appears below, registrant is deemed to confirm being at least of the age eighteen.   And I do hereby, grant permission of any photos taken during the tour to be used in the redesign of any future web page for the Appalachian Bike Tour. SIGNATURE:__________________________________ _______________________________________________ Parent or Guardian's Signature, if rider is less than 18 years old: You may make copies of registration forms if needed
Sponsors:  Lawrence County Democratic Woman's Club                All Proceeds go to the Appalachian Bike Tour Scholarship Fund: All Fees and Donations are Tax Deductible  Endorsed by the Ashland Cycling Enthusiasts