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Registration for Ride and Wine Cycling Event 2017 : Friday, September 08, 2017 8:00 AM


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Registration for Ride and Wine Cycling Event 2017 :

* Category
* First Name
* Last Name
Participant Address
* Address line 1
Address line 2
* City
* State
Province
* Postal code
* Country
* Email Address
* Phone Number
* Birthdate
* Gender
* T-Shirt Size:
We are in need of volunteers as well! If you are able to volunteer, please choose one of the areas that you would be of best use.
* Waiver

I know that bike riding in an event is a potentially hazardous activity. I agree I will not participate if I am under the influence of alcohol or drugs. I will not enter and participate unless I am medically able and properly trained. I agree to abide by any decision of an event official relative to my ability to safely complete the event. I assume all risks associated with participating in this event including, but not limited to: falls, contact with other participants, pubic road traffic, the effects of the weather, including high heat and/or humidity, traffic, and the conditions of the road, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release the Central Virginia Cycling Association, Inc and its officers, director, and agents, all other sponsors, their representatives, and successors from all claims or liabilities of any kind arising out of my participation in this event even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver.

Initial to agree to the above waiver:  
* Safety Agreement

I understand I must provide my own white light on the front of my bike and a red light on the back of my bike. I understand I must wear a helmet at all times. I understand that I must follow all State road signs and State highway laws. I understand I will not be allowed to participate if I don't abide by all safety requirements.

Initial to agree to the above waiver:  



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