Brian Smith Ride
Brian Smith Charity Bike Ride

Event Date: Sunday May 27 2012
Event Location: Burlington, ON
Start Time: 140km-8:00 a.m, 76km-9:30 a.m, 50km-10:00 a.m
Distances:  140K, 76K & 50K.
Event Contact Info:  Website www.briansmithride.ca    

Online registration will close at 6pm on May 25, 2012

Registration Instructions
  1. Enter the required information below.
  2. Confirm the information you entered and get total to be charged.
  3. Enter your credit card information.
  4. Transaction is processed and a receipt is emailed to the address you supplied.
  5. Check the online confirmation list. If there are any questions about your online registration please contact us at briansmith@onlineregistrations.ca.

All fees non-refundable and non-transferable.
Required information is marked with a red asterisk (*).

Choose one Event Race Fee
50km $50
76km $50
140km $50
* A transaction fee will be applied.
Enter Your Personal Information
*First Name:
*Last Name:
*Email Address: (your receipt will be emailed to this address)
*Phone (+ area code): ( )-
*Gender: female        male
*Age:
*Street:
*City:
*Prov./State:
*Postal/Zip Code:
 
Release Waiver and Indemnity

In consideration of the acceptance of my application and the permission to participate as an entrant or competitor in the Brian Smith Charity Bike Ride to be held on Sunday May 27 2012, I for myself, my heirs, executors, administrators, successors and assigns, HEREBY RELEASE, WAIVE AND FOREVER DISCHARGE, the Brian Smith Charity Bike Ride committee, Her Majesty The Queen in Right of Ontario as represented by the Ministry of Natural Resources, Foot Tools and all other associations, sponsoring companies and all their respective agents, officials, affiliates, servants, contractors, representatives, successors and assigns, OF AND FROM ALL liability, claims, demands, damages, costs, expenses, actions and causes of actions whether in law or equity, in respect of death, injury, loss or damage to my person or property HOWSOEVER CAUSED, arising or to arise by reason of my participation in this event, whether as a spectator, participant, competitor or otherwise, whether prior to, during or subsequent to the event AND NOTWITHSTANDING that such death, injury, loss or damage may have been contributed to or caused solely or partly by the negligence of any of the aforementioned. I verify that I am fully aware of the physical risk of injury or death by participating in this event and voluntarily agree to accept full responsibility and legal liability for same, and that I am fit and have trained sufficiently for this event. I FURTHER HEREBY UNDERTAKE TO HOLD AND SAVE HARMLESS AND AGREE TO INDEMNIFY all of the aforementioned from and against any and all liability incurred by any and all of them arising as a result of, or in any way connected with, my participation in this event. BY SUBMITTING this ENTRY,

I HEREBY ACKNOWLEDGE AND AGREE that I have CAREFULLY READ THIS WAIVER, RELEASE and INDEMNIFICATION and that I fully UNDERSTAND AND AGREE to same, and I WARRANT that I am physically fit to participate in this event.

I ATTEST AND VERIFY THAT I AM 18 YEARS OF AGE OR THAT I AM SIGNING AS THE LEGAL GUARDIAN ON BEHALF OF AN EVENT PARTICIPANT UNDER THE AGE OF 18 YEARS.

Agreeing to this waiver and registering online for this race by me, for myself or as legal guardian of an event participant, in an electronic format authorizes you to accept this waiver as signed by me.

 

I have read and agree to the waiver.

Parents name if under 18 years of age

 
 

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