Please Print
Name_____________________________
Address___________________________
City_______________________________
State______________________________
Zip_______________________________
Age________ Male______ Female______
Email _____________________________
T-Shirts Check One
S____ M____ L____ XL____2XL____
Distance in Miles Check One
15m___ 27m___ 57m___
70m___85m___102m___
Entry Fee Amount Enclosed Check One
_____$25 Pre-Registration Fee
(Must be received Before March 20nd, 2008)
_____$30 On-Site Registration Fee
(T-Shirt Not Guaranteed with On-Site Reg.)
Waiver of Claim
Waiver of Claim (must be signed) in consideration of the acceptance of the registration entry. I, the undersigned, assume full responsibility for any injury or accident which may occur during my participation in any of the Salado Smokin' Spokes events, and I hereby hold harmless the sponsors, promoters or other persons or entities associated with the event. I understand that a bicycle is a legal vehicle in the state of Texas and that I must ride in a legal and safe manner.
Rider's Signature____________________________
Date________________________________
Parent's Signature________________________
(if rider is under 18 years of age)
Make checks payable to:
Salado Fire Department
Mail Entry to:
Salado FD Bike Ride
P.O. Box 503
Salado, TX 76571
