CWI 2nd Century Ride - Registration 2009
Sunday, September 13, 2009 @ 7:30am
Telvent, 4701 Royal Vista Circle, Fort Collins, CO 80528 - South Parking Lot
Form
First Name
Last Name
Phone
Mobile
Address1
Address2
City
State
Select a State
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Texas
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Country
Select a Country
Abkhazia
Afghanistan
Aland
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Ascension
Ashmore and Cartier Islands
Australia
Australian Antarctic Territory
Austria
Azerbaijan
Bahamas, The
Bahrain
Baker Island
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Antarctic Territory
British Indian Ocean Territory
British Sovereign Base Areas
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China, People's Republic of
China, Republic of (Taiwan)
Christmas Island
Clipperton Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo, Democratic Republic of the (Congo Kinshasa)
Congo, Republic of the (Congo Brazzaville)
Cook Islands
Coral Sea Islands
Costa Rica
Cote d'Ivoire (Ivory Coast)
Croatia
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Finland
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French Southern and Antarctic Lands
Gabon
Gambia, The
Georgia
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Greenland
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India
Indonesia
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Iraq
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Isle of Man
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Italy
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Japan
Jarvis Island
Jersey
Johnston Atoll
Jordan
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Kenya
Kingman Reef
Kiribati
Korea, Democratic People's Republic of (North Korea)
Korea, Republic of (South Korea)
Kosovo
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Laos
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Liberia
Libya
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Lithuania
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Malta
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Mauritius
Mayotte
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Midway Islands
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar (Burma)
Nagorno-Karabakh
Namibia
Nauru
Navassa Island
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Cyprus
Northern Mariana Islands
Norway
Oman
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Palestine
Palmyra Atoll
Panama
Papua New Guinea
Paraguay
Peru
Peter I Island
Philippines
Pitcairn Islands
Poland
Portugal
Pridnestrovie (Transnistria)
Puerto Rico
Qatar
Queen Maud Land
Reunion
Romania
Ross Dependency
Russia
Rwanda
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Georgia and the South Sandwich Islands
South Ossetia
Spain
Sri Lanka
Sudan
Suriname
Svalbard
Swaziland
Sweden
Switzerland
Syria
Tajikistan
Tanzania
Thailand
Timor-Leste (East Timor)
Togo
Tokelau
Tonga
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
U.S. Virgin Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Viet Nam
Wake Island
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
E-mail
Postal/Zip
Are you cycling the whole route?
Heck Yeah!
50-mile Loop
25-mile Out & Back
Other
Other Length
If you entered Other for the Route, please enter length of your ride.
Donation
$10
Other
Other Amount
If you entered Other for Donation, please enter amount.
Payment Method
Pre-pay at HQ
At Event
WAIVER
Please read the text below and click on "Submit" to agree to the waiver. You may be asked to sign a hard copy at check-in. Clicking on "Submit" will also submit your registration. Enjoy the ride!
IN CONSIDERATION of being permitted to participate in any way in Colorado Wheeltime IT (Club) sponsored Bicycling Activities (Activity) I, for myself, my personal representatives, assigns, heirs, and next of kin:
1. ACKNOWLEDGE, agree, and represent that I understand the nature of Bicycling Activities and that I am qualified, in good health, and in proper physical condition to participate in such Activity. I further acknowledge that the Activity will be conducted over public roads and facilities open to the public during the Activity and upon which the hazards of traveling are to be expected. I further agree and warrant that if, at any time, I believe conditions to be unsafe, I will immediately discontinue further participation in the Activity.
2. FULLY UNDERSTAND that (a) BICYCLING ACTIVITIES INVOLVE RISK AND DANGERS OF SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABLITY, PARALYSIS AND DEATH (Risk); (b) these Risks and dangers may be caused by my own actions, or inactions, the actions or inactions of others participating in the Activity, the condition in which the Activity takes place, or THE NEGLIGENCE OF THE RELEASEES NAMED BELOW; (c) there may be OTHER RISKS AND SOCIAL AND ECONOMIC LOSSES either not known to me or not readily foreseeable at this time; and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COST AND DAMAGES I incur as result of my participation in the Activity.
3. HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE the Club, the League of American Bicyclists (LAB), their respective administrators, agents, officers, members, volunteers, and employees, other participants, any sponsors, advertisers, and, if applicable, owners and lessors of premises on which the Activity takes place, (each considered one of the RELEASEES herein) FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON MY ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS; AND I FURTHER AGREE that if, despite this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT I, or anyone on my behalf, makes a claim against any of the Releasees, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES from any litigation expenses, attorney fees, loss, liability, damage, or cost which any may incur as the result of such claim.
I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY ACCEPTING IT, AND HAVE ACCEPTED IT FREELY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID, THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT.
Submit
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