DOUBLE
DIVIDE RIDE ENTRY FORM
Saturday and Sunday, August 25 and 26, 2001
Please print legibly. Pre-registration deadline – must be postmarked by August 10. Save $$$ – REGISTER EARLY! Participants will receive registration confirmation upon receipt of entry form.To enter, please print and complete this form and return it along with a check or money order payable to Helena Bicycle Club. One rider per form.
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First Name |
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Address |
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Emergency Contact – Please list someone NOT on the Double Divide ride.
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Registration Fees (please check appropriate boxes) – Your registration fee includes a t-shirt, meals, and rest stop refreshments.
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o Double Divide Ride Fee (non-club member, over the age of 16) $65.00 |
$ |
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o Double Divide Ride Fee (Helena Bicycle Club member, over the age of 16) $50.00 |
$ |
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o Double Divide Ride Fee (youth, 16 years or under) $25.00 |
$ |
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o Helena Bicycle Club Membership (become a member now and pay discounted member registration fee) $15.00 |
$ |
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o Late Fee (must be included with registration fee if registering after August 10) $10.00 |
$ |
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TOTAL Check or money order for this amount should be enclosed |
$ |
Please check appropriate box. T-shirt Size, Adult: o Medium, o Large, o X-Large, or o XX-Large
Representation and Acknowledgement:
I hereby represent that I am in good physical condition for this ride. I understand the route is challenging and not chosen for its safety. I understand that this is a non-competitive event and not a race. I further represent I have the ability and equipment to handle the route and any weather conditions. I agree to wear an ANSI-approved bicycle helmet, and I understand a rear-view mirror is recommended.
Release from Liability:
In consideration of the acceptance of the registration, by signing this release (parent or guardian, if registrant is under 18 years of age), I hereby release for myself and my kin, and waive any claims of action against the Helena Bicycle Club, its officers, directors, members, agents and all other persons or entities from all liability arising out of any injury to persons or property, and any loss, damage or expenses arising out of my participation in this ride.
Application is not valid without signature!
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Signature of Participant |
Signature of parent or guardian, if participant under 18 years of age |
Date |
Pre-register by August 6 to save money. Advance registration is requested. Check-in between 7 and 8 a.m. at the Broadwater Athletic Club, just west of Helena on Highway 12.Registration
Baggage Check your baggage at registration. Please limit gear to one bag, plus sleeping bag and tent (tent optional). The baggage truck will go directly to Lincoln, so carry whatever items you need during the ride. On Sunday, your gear will arrive back at the Broadwater by 11 a.m.
Showers Showers are available in Lincoln at the school for Saturday night and at the Broadwater Athletic Club on Sunday.
Sag Support services will be available for any mechanical problems along the route.
Overnight Accommodations Sleep indoors at the Lincoln School on Saturday night, or bring a tent to camp outside on the school grounds. If you prefer not to take advantage of the free accommodations at the school, there are several motels in Lincoln. Contact ride director for information.
Waterslide
For an additional fee, spend Sunday afternoon on the waterslide at the Broadwater Athletic Club.Mail form and payment to:
HELENA BICYCLE CLUB, P.O. BOX 4682, HELENA,
MT 59604
