LIABILITY WAIVER

In consideration of the BBC providing bicycling opportunities and allowing me/us to participate in its events, I/we  agree to assume the risks thereof.  Further, I/we release the BBC and its officers, directors, members and agents from any and all claims for death personal injury, or property damage which may accrue to me/us (or a minor in my care) as a result of participation in any BBC activity or event, even though the claim may arise out of negligence or carelessness on the part of the person or entities released.

Signed________________________________________________

____________________________  Parent/Guardian (for minor)

The liability waiver must be signed by each participant before participation.

 

BLAIR BIKE CLUB

636 N 20TH AVE

Blair, NE  68008

Proceeds to be donated.

www.blairbikeclub.com

This Cool Art (above) on River Ride T-Shirt! 

 

BBC Rollin to the River Century 100

FIFTH ANNUAL!

Entry Form

August 6, 2011 @ 7:30 a.m.  Nannen Physical Therapy-636 N 20th Ave. Blair, NE

Name____________________

Address___________________

City______________________

State_____Zip_____________

Phone____________________

Email_____________________

Distance (miles)

 (  ) 20    (  ) 36    (  ) 56    (  ) 68  

(  ) 100  --Is this your first century? ______

Registration fee                 $22     $_______

(Registration for individual is $18 if postmarked before 7/20/11)

Registration-family   $38              $ ______

Registration fee Ages 65   $18    $______

                                     T-shirt (order by 8/1)    $5     $ ______ 

Join BBC (optional)   $10            $ ______

              Total submitted:      $____________

T-Shirt size (must register by 8/1 to get a shirt on 8/6)  

(  )S  (  )M  (  )L  (  )XL  (  )XXL (add $2)

Registrations welcome day of ride.  Please send your completed registration form and liability waiver to:

   BBC
         c/o Nannen PT
          636 N 20th Ave
            Blair, NE 68008

Consider joining the BBC!

We offer:   Club Rides... Summer Time Trials... Bowling events, etc, etc!!!