Miles (Circle One) 125 90 70 50
Cost $65 (members) $75 (nonmembers)
Make Checks payable to Bicycle Club of Philadelphia
Buses leave the Art Museum at 6:00 AM with your baggage for those taking the bus to New Hope and other starts, and leave New Hope at 7:30 for the 70 and 50 mile starts. Buses leave New York at 9:00 PM SHARP.
Name ________________________________________________________
Address _____________________________________________________
City _______________________________State____ Zip ________
Telephone ___________________________________
Cell Phone on the day of the Ride _______________________
E-mail ______________________________________
Bicycle Club of Philadelphia Release
(Must be signed by each participant)
In signing this release for myself or for the named applicant, if applicant is under the age of 18, I understand that participation in Bicycle Club of Philadelphia (“BCP”) activities is at my own risk. I acknowledge the risks and dangers inherent with such activities and knowingly and voluntarily assume the risk of injury resulting there from. I understand that supervision, training or oversight may not be provided by BCP with respect to all sponsored events and activities. Participation in BCP activities constitutes my representation that (1) I am in good health, (2) I agree to obey all traffic laws and regulations and practice safety and courtesy in cycling, (3) I agree to wear an approved safety helmet on all BCP sponsored rides, (4) my bicycle is in good and safe mechanical condition, and (5) I acknowledge that BCP and its directors, officers, members, contributors, sponsors, ride leaders and other event coordinators are not insurers of my personal safety or property and do not assume any liability for personal injury or property loss sustained during any BCP sponsored events or activities. By signing below and in consideration for being allowed to participate in any BCP sponsored event or activity, I fully release BCP and its directors, officers, members, contributors, sponsors, ride leaders and other event coordinators from any liability, specifically but not limited to liability for their negligent acts, stemming from or relating to past or future BCP sponsored events or activities.
Signature ____________________________________
Date _______________________________________
In case of emergency, please call:
Name ______________________________________
Telephone ___________________________________
Address ____________________________________
___________________________________________