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ACBR Registration
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Here is this year's year's entry form for the Atlantic Canada Bicycle Rally. If you can download and print "Adobe pdf" files you will find it much easier than printing off the web page.
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Adobe Reader required for the forms is free from the Adobe Web site
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Participant info
NOTE: Registration is limited. You will be notified immediately if the tour is filled.
Last Name .......First ..........Middle
Street Address or Box No.
City Province/State Postal Code/Zip
Phone
Age if 18 or younger
E-mail address (if any) Fax number (if any)
Special conditions/ restrictions in case of medical emergency?
Club Affiliation (if any)
__Send information on transportation to tour
__Bringing Tandem
__Bringing Recumbent Bike
__Require other information- specify:
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ACBR Entry selections
Canadian and US currency was equal at time of this form. Entry is by way of personal cheque or money order. PayPal and wire transfer are also available, please contact us. (Note - U.S. "green" domestic postal money orders cannot be used in Canada).
The first 150 entries include a 2008 ACBR souvenir
[
Registration
(Family Rates - parents and children/youth 18 and under. Children 5 and under free)
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Number |
Amount |
Total |
Adult(s) (before June 15)
Family (before June 15) |
___
___ |
$55
$106 |
$____
$____ |
Adult(s) (June 15 to July 19)
Family (June 15 to July 19) |
___
___ |
$64
$123 |
$____
$____ |
Adult(s) (after July 19)
Family (after July 19) |
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___ |
$75
$144 |
$____
$____ |
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Saturday Picnic BBQ |
Number |
Amount |
Total |
Adult(s)
Child(ren) (12 and under) |
___
___ |
$20
$15 |
$____
$____ |
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Sunday ACBR Banquet |
Number |
Amount |
Total |
Adult(s) Beef
Adult(s) Vegetarian
Adult(s) Lobster
Child(ren) (12 and under) Beef
Child(ren) (12 and under) Vegetarian
Child(ren) (12 and under) Lobster |
___
___
___
___
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___ |
$30
$30
$40
$20
$20
$30 |
$____
$____
$____
$____
$____
$____ |
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Breakfasts/ Lunches
(Saturday, Sunday and Monday) |
Number |
Amount |
Total |
Adult (s)
Child(ren) (12 and under) |
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$66
$58 |
$____
$____ |
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Camping
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Number |
Amount |
Total |
| (per tent - Saturday, Sunday and Monday) |
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$57 |
$____ |
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2008 ACBR T-Shirts
(very few will be on hand at the event) |
Number |
Amount |
Total |
__S __M __L __XL __XXL |
___ |
$20 |
$____ |
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Final Total |
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Waiver
WAIVER: ALL PARTICIPANTS MUST READ AND SIGN
I have read and agree to the supplied terms and conditions. I understand that participation in the Atlantic Canada Bicycle Rally involves riding on public roads used by other traffic and am aware of the hazards involved in that and in riding bicycles in general. I understand that I may be injured while bicycling or otherwise participating in this event, and I agree to be responsible for my actions. I consent to emergency medical treatment in the event of injury. I further state that I am in proper physical condition to participate in this event. In my judgment I have/my child has sufficient competence and experience to participate safely in such riding. I promise to release and hold harmless the operators of Atlantic Canada Cycling, and all sponsors, stakeholders, and all other persons involved in the organization or acts of omission concerning the Atlantic Canada Bicycle Rally from all actions, proceedings, demands, costs, expenses and claims whatsoever made or taken by any person arising out of my participation in the Atlantic Canada Bicycle Rally . In case of a minor aged entrant, I agree to indemnify and hold harmless the above parties from any claims for injury or damages which said minor may sustain. Conduct which, in the opinion of the organizers, threatens the safety of other cyclists, or unsociable behaviour may result in exclusion from the Atlantic Canada Bicycle Rally without refund. Atlantic Canada Cycling reserves the right to change the route from that described in this form without notice. Numbers of those participating is at the discretion of the organizers and they have the right to refuse any entry. I agree to abide by the rules of the road as set out under provincial and municipal statutes and regulations. I further warrant that I will maintain my bicycle in safe operating condition. In the event that this Contract, in part or in whole, shall to any extent be invalid or unenforceable, then the remaining portions of this Contract shall continue to be valid and enforceable. In any event, the liability of Atlantic Canada Cycling, and its officers shall be limited to the amount of Two Hundred and Fifty ($250) Dollars.
________________________ _________
Signature of Entrant.......................Date
Participants 18 years of age or under must be accompanied by a chaperone who is aged 21 years of age or older who will be responsible for the younger entrant. Please state the name in full of chaperone.
________________________ _________
Parent/ Guardian Signature ...........Date
(for riders 18 or under)
:________________________ _________
Signature of Chaperone ................Date
Print Chaperone name:_________________
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Applying for the Rally
Rally entry is made by cheque or money order through postal mail. We can hold a place for you for two weeks by notification by E-mail, phone, or fax. You will be notified immediately if any functions at the ACBR are filled.
For further information on this year's ACBR contact:
Atlantic Canada Bicycle Rally
c/o Atlantic Canada Cycling
acbr@atlanticcanadacycling.com
PO Box 1555, Station Central
Halifax, Nova Scotia, Canada B3J 2Y3
(902) 423-BIKE; fax (902) 423-2452 |
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www.atlanticcanadacycling.com
Copyright © 2008 Atlantic Canada Cycling. All
Rights Reserved.
Atlantic Canada Cycling, Atlantic Canada Bicycle Rally, and Cabot
Trail Bicycle Tour logos are service marks of Atlantic Canada Cycling.
Unless expressly permitted, the material obtained from or through
the Atlantic Canada Cycling Information Site may not be reproduced,
stored in an electronic retrieval system, or transmitted in any form
or by any means physical, electronic or otherwise. Refer to details
Trail Bicycle Tour logos are service marks of Atlantic Canada Cycling.
Unless expressly permitted, the material obtained from or through
the Atlantic Canada Cycling Information Site may not be reproduced,
stored in an electronic retrieval system, or transmitted in any form
or by any means physical, electronic or otherwise. Refer to details
in our Copyright
- Terms of Use Statements. |
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