Lobster Roll Relay - Registration (under 19 years old)

published by J. Cote on Thu, 2012-04-05 15:39

Fee Schedule

up to June 16^th. $5.

Team Name

First & Last Names *

Address *

City, Prov., Postal Code *

Age (by June 17, 2012) *

Telephone

eMail *

Parent/Guardian's Names *

For a participant under 19 years of age, Parent/Guradian's approval is required.

Waiver

I/we hereby release the Velo Cape Breton Bicycle Association, its officers, directors, members and volunteers from any and all liability claims, causes of actions, of any kind whatsoever, in respect of injuries and/or damages I/(my child) may suffer as a result of me (or my child) sustaining personal injury, death or property damage or loss while participating in the Lobster Roll Relay event.

In Lieu of a Signed Waiver, Do You Accept the Above Release? *

Yes

(Please print this membership form for your records before proceeding to the payment page.)

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Lobster Roll Relay - Registration (under 19 years old)

Waiver

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2013 Programs

Velo Cape Breton newsletter

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Lobster Roll Relay - Registration (under 19 years old)

Waiver