(1) Put the checkmark by your choice, EITHER adult or child, (2) make a selection from each of the three pulldowns, then (3) click the submit button only once!!

Register ONE ADULT for the Tour de Rogers on 8/23/08 Entry fee is $38.50, which includes $2.50 processing fee for online registration and $10 late reg fee after 08/17.

Register ONE CHILD (12 and under)for the Tour de Rogers on 8/23/08 Entry fee is $27.50, which includes $2.50 processing fee for online registration.

Select T-Shirt Size Thanks but No T Adult Small Adult Medium Adult Large Adult XL Adult XXL Adult XXXL Note: Adult XXL and XXXL are $15.00 each

Select Distance Option 6 mile bike ride 20 mile bike ride 35 mile bike ride 58 mile bike ride 68 mile bike ride 100 mile bike ride Walk/Run 1.5 Miles Walk/Run 4 miles Undecided

Make an Optional Additional Contribution Not at this Time $10 Contribution $25 Contribution $50 Contribution $100 Contribution $500 Contribution $1000 Contribution (Incurs 10% processing fee)

Waiver - I ACKNOWLEDGE THAT BY CHECKING THIS BOX, I AM RELEASING Promoters of the Tour de Rogers and their RESPECTIVE AGENTS, EMPLOYEES, MEMBERS, SPONSORS, PROMOTERS AND AFFILIATES (COLLECTIVELY RELEASEES’) FROM LIABILITY. THIS ENTRY BLANK AND RELEASE IS A CONTRACT WITH LEGAL CONSEQUENCES. I HAVE BEEN ADVISED TO READ IT CAREFULLY BEFORE SIGNING. In consideration of the Releasee’s acceptance of my application for entry in the above event. I hereby freely agree to and make the following contractual representations and agreements. I acknowledge that cycling is an inherently dangerous sport and fully realize the dangers of participating in a bicycle event and FULLY ASSUME THE RISKS ASSOCIATED WITH SUCH PARTICIPATION INCLUDING, by way of example, and not limitation, the following: the dangers of collision with pedestrians, vehicles, other participants, and fixed or moving objects: the dangers arising from surface hazards, equipment failure, inadequate safety equipment, THE RELEASEES’ OWN NEGLIGENCE, and weather conditions; and the possibility of serious physical and/or mental trauma or injury associated with athletic cycling and or walking. For myself, my heirs, executors, administrators, legal representatives, assignees, and successors in interest (collectively “Successors”) I HEREBY WAIVE, RELEASE, DISCHARGE, HOLD HARMLESS, AND PROMISE TO INDEMNIFY AND NOT TO SUE the Releasee’s and the sponsors of this event, the organizer and any promoting organizations, property owners, law enforcement agencies, all public entities, special districts and properties, and their respective agents, officials, and employees through or by which the events will be held, (the foregoing are also collectively deemed to be Releasee’s), FROM ANY and all rights and CLAIMS INCLUDING CLAIMS ARISING FROM THE RELEASEES’ OWN NEGLIGENCE, which I have or which may hereafter accrue to me and from any and all damages which may be sustained by me directly or indirectly in connection with, or arising out of, my participation in or association with the event, or travel to or return from the event. I agree it is my sole responsibility to be familiar with the course, the Releasee’s rules, and any special regulations for the event. I understand and agree that situations may arise during the event, which may be beyond the immediate control of the event organizers, and I must continually ride or walk so as to neither endanger myself or others. I accept responsibility for the condition and adequacy of my equipment. I will participate wearing a helmet that can protect against serious head injury, and assume all responsibility and liability for the selection of such a helmet. I have no physical or medical condition which to my knowledge, would endanger others or myself if I participate in this event, or would interfere with my ability to participate in this event. I agree, for myself and my successors, that the above representations are contractually binding, and are not mere recitals, and that should I or my successors assert my claim in contravention of this agreement, the asserting party shall be liable for the expenses (including legal fees) incurred by the other party or parties in defending, unless the other party or parties are finally adjudged liable on such claim for willful and wanton negligence. This agreement may not be modified orally, and a waiver of any provision shall not be construed as a modification of any other provision herein or as consent to any other provision herein or as consent to any subsequent waiver or modification. Every term and provision of this agreement is intended to be severable. If any one or more of them is found to be unenforceable or invalid, that shall not affect the other terms and provisions, which shall remain binding and enforceable.

* I HAVE READ, I UNDERSTAND, AND I AGREE TO THE ABOVE WAIVER.
I further agree to sign waivers onsite as requested on event day and
that an adult will be present to sign for me if I am 18 years old or younger.

Participant's name is entered on Payments page.

YOU WILL RECEIVE A CONFIRMATION EMAIL/INVOICE
TO PRINT AND BRING TO THE EVENT(S) AS YOUR TICKET