FOOD BANK OF WNY

CHOPPERS FOR CHARITY

& HOGS AGAINST HUNGER

BENEFIT RUN & PARTY

SATURDAY, APRIL 24, 2010
REGISTRATION & WAIVER FORM

Day of Event Run Registration Fee:
  $15 for riders, $10 for passengers.


*** For faster check-in at Native Pride, you may print and bring this completed form to registration. ***

 

Pre-Registration Run Fee:  $10 for riders, $5 for passengers.
Deadline:  April 17, 2010

*** Stop at the “Express” table at Native Pride Travel Plaza to get your wristband! ***

 

Party Only Pre-Sale Donation:  $10. 
Deadline:  April 17, 2010

*** Stop at the “Express” table at Club Paradise to get your wristband!  Day of Event:  $15. ***

 

First Name:
Last Name:
Address: 
City: State:    Zip:
Telephone:
E-mail: 
Name on Card:
Credit Card: 
Card Number:
Expires:
Amount: $ .00

WAIVER: FOR MOTORCYCLES/CARS PARTICIPATING IN THIS RUN ONLY I know that riding a motorcycle/car is a potentially hazardous activity. I should not enter unless I am medically able and properly trained. I also know that there will be traffic, hazards, debris, etc. on the course and assume the risk for riding on it. I also assume any or all other risks associated with motorcycle/car riding or attending the event, including but not limited to falls, contact with other participants, the effects of the weather, the conditions of the roads and getting lost, all such risks being known and appreciated by me. Knowing these facts, and in consideration of your accepting my entry fee, I hereby for myself, my heirs, executors, administrators or anyone else who might claim on my behalf, covenant not to sue, and waive, release and discharge the Food Bank of WNY, its staff and Board, all owners of the properties on which the ride is run or held, all municipalities in which the event is held, the ride committee, volunteers, all other organizations directly or indirectly associated with the ride, any or all sponsors including their agency, employees, assigns or anyone acting on their behalf, or anyone else associated in any way with this ride, from any or all claims or liability for death, personal injury or property damage of any kind or nature whatsoever arising out of, or in the course of, my participation in this event. This waiver extends to all claims of every kind or nature whatsoever; foreseen or unforeseen, known or unknown. By entering this ride, I am granting permission to all parties affiliated with this benefit to use any pictures or likenesses of me secured at the event in any way they see fit without review, restriction, or compensation.

I HAVE READ AND UNDERSTAND THIS WAIVER:

Driver Date Passenger Date