Registration Form

WHEN YOU SELECT THIS CHECKBOX, YOUR SELECTION IS THE SAME AS A SIGNATURE. YOU ARE ACKNOWLEDGING THAT YOU HAVE READ THE RESPONSIBILITY WAIVER AND ARE AGREEING TO THE TERMS PRESENTED. **MUST BE CHECKED TO PARTICIPATE IN THE EVENT" IN CONSIDERATION OF BEING PERMITTED TO PARTICIPATE IN THE JOURNEY OF HOPE RIDE AND TO PARTICIPATE IN THE PROVIDED ACTIVITIES ON AUGUST 20, 2011, OR ANY OTHER DATE THE EVENT TAKES PLACE, I HEREBY FOR MYSELF, MY HEIRS AND PERSONAL REPRESENTATIVES ASSUME ANY AND ALL RISKS WHICH MIGHT BE ASSCOCIATED WITH THE EVENT AND I FURTHER WAIVE, RELEASE, DISCHARGE AND COVENANT NOT TO SUE THE ALS ASSOCIATION, OR ANY ONE INVOLVED WITH ORGANIZING THIS EVENT, OR ANY OF THEIR AFFILIATES OR SUCCESSORS AND ASSIGNS, FOR INJURIES OR DAMAGES OF ANY KIND WHATSOEVER SUFFERED AS A RESULT OF TAKING PART IN THE EVENT AND RELATED ACTIVITIES.


	Rider
First Name *
Last Name *
MI
Mailing Address *
City *
State *
Zip *
Home Phone #
Cell Phone #
Email Address
Club Name
	Passenger
	Non-Paid Passenger/No chance to win prizes
First Name
Last Name
MI
Mailing Address
City
State
Zip
Home Phone #
Cell Phone #
Email
Club Name
*	WHEN YOU SELECT THIS CHECKBOX, YOUR SELECTION IS THE SAME AS A SIGNATURE. YOU ARE ACKNOWLEDGING THAT YOU HAVE READ THE RESPONSIBILITY WAIVER AND ARE AGREEING TO THE TERMS PRESENTED. **MUST BE CHECKED TO PARTICIPATE IN THE EVENT" IN CONSIDERATION OF BEING PERMITTED TO PARTICIPATE IN THE JOURNEY OF HOPE RIDE AND TO PARTICIPATE IN THE PROVIDED ACTIVITIES ON AUGUST 20, 2011, OR ANY OTHER DATE THE EVENT TAKES PLACE, I HEREBY FOR MYSELF, MY HEIRS AND PERSONAL REPRESENTATIVES ASSUME ANY AND ALL RISKS WHICH MIGHT BE ASSCOCIATED WITH THE EVENT AND I FURTHER WAIVE, RELEASE, DISCHARGE AND COVENANT NOT TO SUE THE ALS ASSOCIATION, OR ANY ONE INVOLVED WITH ORGANIZING THIS EVENT, OR ANY OF THEIR AFFILIATES OR SUCCESSORS AND ASSIGNS, FOR INJURIES OR DAMAGES OF ANY KIND WHATSOEVER SUFFERED AS A RESULT OF TAKING PART IN THE EVENT AND RELATED ACTIVITIES.