PAYMENT INFORMATION
Registration fee
Day of event registration
fee
$45
Unfortunately, I will
be unable to participate in Champ Ride, but I would like to offer a
tax-deductible contribution of:
$
Please choose one of
the following payment options:
I will send my payment to
Vermont CARES, P.O. Box 5248, Burlington, VT 05402.
Please call me for my Visa
or Mastercard number.
*Please note that your
registration will not be complete until we receive payment. Your rider number
and registration packet will be sent out after we receive payment. Thank you!
All cyclists must raise a minimum of
$50.00 in pledges in addition to the registration fee.
We welcome any other comments or questions
you may have:
WAIVER AND RELEASE (required)
I am voluntarily
participating in Champ Ride and understand that I will be using public
streets and facilities where hazards may exist and am aware of the risks
which may result. I acknowledge the dangers involved and I agree to accept
any and all risks of injury. I acknowledge that I am solely responsible for
my personal health and safety and the condition of the bicycle I will be
riding. Therefore I hereby waive all claims against Vermont CARES, event
sponsors or any employees for any injury I might suffer in this event. In
addition, I understand that my photograph may be used by Vermont CARES for future
promotions. I have carefully read this Waiver and Release and fully
understand its contents. By submitting this form, I indicate my acceptance of
the Waiver and Release.
Press
button above or Enter key to submit completed form.
