2008 Brandon Lions Ramble 100

An Organized Bicycle Ride

April 19, 2008

"The Annual Brandon Lions Ride for Sight"
REGISTRATION FORM

(Print out, complete, and mail with payment to: 2008 Brandon Lions Ramble 100, c/o Adam Buzbee 1308 Willow Valley Dr., Brandon, FL 33510)

Name __________________________________________________________

Street Address ___________________________________________________

City____________________________________State_____ ZIP___________

Age_________   Shirt Size (circle size) (S   M   L   XL   XXL)

Ride most likely to ride (circle one) ( 12   25   50   100 )

ALL RIDERS ARE REQUIRED TO WEAR AN ANSI OR SNELL APPROVED HELMET.

APPLICATION NOT VALID WITHOUT SIGNED RELEASE BELOW

Make checks payable to: BRANDON LIONS CLUB

RELEASE of organizers and sponsors

Waiver: I hereby for myself, my heirs, executors, agents and administrators, waive and release any and all rights and claims for damages that I may have against the Brandon Lions Club and its respective agents, representatives, successors and assignees for any and all injuries which may be suffered by me in connection with my participation in this bicycle ride.

Signature of Rider(s)_________________________________________

Signature of parent or guardian ________________________________
(for riders under 18)

Dated____________________

All riders under 14 must be accompanied by a responsible adult.

REGISTRATION:

• $20.00 for preregistration by April 4, 2008.
  All riders who are preregistered by April 4, 2008 will receive a free T-shirt.
  
  
• $25.00 for registration after April 4, 2008 and on the day of the ride.
  Riders who register after April 4, 2008 will not receive a free T-shirt.