The St. Ansgar Lions Club and START (St. Ansgar
Recreational Trail Committee) or anyone helping with this ride
assumes NO responsibility for personal injury, property damage, theft
or loss during this event. Each participant is responsible for
obeying all traffic regulations and personal safety while riding. All
cyclists ride at their own risk and agree to hold the St. Ansgar
Lions Club and START, their officers and leaders blameless in case of
accident or injury. Any cyclist under the age of 18 must be
accompanied by a responsible adult. A parent or guardian must sign
for applicants under the age of 18.
All applications must be signed, and in signing the liability
release, I agree to the above conditions. Early returned
registrations will assure proper shirt size.
Registration form and liability release:
NAME______________________________________
SIGNATURE____________________________________
ADDRESS ___________________________________ AGE____________
PHONE___________________________
CITY______________________________________ STATE____________________
ZIP_____________________
PARENT OR GUARDIAN SIGNATURE (for
minor)________________________________________________
TO PRE-REGISTER, SEND CHECK or MONEY ORDER and SHIRT SIZE TO:
2 x 4 Bike Ride
St. Ansgar Lions Club
PO Box 505
St. Ansgar, IA 50472
T-Shirt Sizes: S-M-L-XL-XXL
FEE:
$15.00 per Adult
$10.00 per Child
$35.00 Per Family