Ride for Kurtie 2008

Riders and Passengers - Register Today!

1. Please fill out the information:
RIDER 1		RIDER 2
	Name:		Name:
	Address:		Address:
	Phone:		Phone:
	Email:		Email:

2. Read the Waiver and check the Checkmark:
WAIVER AND RELEASE I agree and will hold harmless the Kurtie Merkendorfer Fund, corporate sponsors, cooperating organizations and all parties connected with the Ride for Kurtie for any liability as a result of my participation, including travel to and from the event. I will permit any emergency treatment in the event of injury or illness while participating in the event. I give my permission to the Kurtie Merkendorfer Fund to use my name and photo taken of me during the event in any promotional material, publication or on the website. The Kurtie Merkendorfer Fund withholds the right to dismiss anyone that my cause any disturbance. I certify that I have read this waiver and release and understand its intent. I understand the entry fee is non refundable and nontransferable.
I agree
3. After clicking the Submit Button, you will be able to securely pay with PayPal.