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MS Bike Event Registration

The Town of Holden Beach’s Bike Ride to benefit the National Multiple Sclerosis Society will held Saturday, May 1, 2010. The event begins at 8 a.m. at Holden Beach Pavilion. Registration is $25 before Feb. 15, $30 between Feb. 16 through Apr. 10 and $35 thereafter. You may choose between a 35-mile route, a 55-mile route, a 100-mile route or a short, free family ride. Complete the form below to register online using a credit card or PayPal or click here to download a printable form that can be mailed with a check. YOUR REGISTRATION IS NOT COMPLETE UNTIL WE RECEIVE YOUR REGISTRATION FEE AFTER YOU COMPLETE THE REGISTRATION FORM, PLEASE PAY USING THE PAYPAL LINK AT THE BOTTOM OF THIS PAGE.

PARTICIPANT INFORMATION

Your Name (required)

Your Address (required)

Your Phone Number (required)

Your Email (required)

Your Tee Shirt Size (required) (NOTE: You must register and pay by April 1 to receive a t-shirt.)

Your Date of Birth (required)



Emergency Contact

Contact Name (required)

Contact Phone (required)

Relation to Participant

Route Choice
 35 miles 55 miles 100 miles Short Family Ride

Release and Waiver

Participants under 18 must have a parent or legal guardian register

Part A – Photo/Model Release
I understand that as part of my participation in the MS Training Ride, photos, videos, and quotations may be taken for use in publications and reports about the program. We further understand that members of the news media invited to cover the program may take photos, videos and quotations. We grant permission to use such materials for the promotion of the program.

Part B – Release and Waiver of Liability and Indemnity Agreement
I hereby release, waive, discharge and indemnify the the Town of Holden Beach NC or any employees associated with the town, the Multiple Sclerosis Society, the owners of all property used in the event, volunteers and or companies helping with the event through way of SAG vehicles, and all other volunteers and save them harmless from and against any and all claims, damages, liability, costs and expenses in connection with loss of life, personal injury, and/or damage to property arising from or out of any occurrence associated with participating in or observing the MS Training Ride sponsored by the town.

I expressly acknowledge and agree that the activities at the MS Training Ride by their nature are dangerous and involve the risk of serious injury and/or death and/or property damage. I further agree that the foregoing release, waiver and indemnity agreement is intended to be as broad and inclusive as is permitted by the laws governing the towns, cities, counties and states where this event is being conducted and that if any portion thereof is held as invalid, it is agreed that the balance shall continue in full legal force and effect.

I have read and voluntarily agree to the release and waiver of liability and indemnity agreement and further state that no oral representations, statements or inducements apart from the foregoing written agreement have been made.

This release, waiver and indemnification agreement specifically embraces each and every phase of the event sanctioned, authorized, offered and/or promoted by said releasees during the entire event and applies to every activity and/or service of the event and has the same effect as if executed after each and every activity of the event in which I am participating so that the parties herein intended to be released and indemnified shall be fully and effectively released and indemnified as to the entire event.

I have read the foregoing Photo/Model Release and Release & Waiver of Liability and Indemnity Agreement, before affixing my consent below and warrant that I fully understand the contents thereof.

Part C – (If participant is under 18 years of age, a parent or guardian must execute in addition to the above, the following waiver)

I, as a parent/quardian of the registrant do hereby represent that I am in fact, acting in such a capacity and agree to save and hold harmless and indemnify each and all of the parties referred to above as releasees from all liability, loss, cost, claim of damage whatsoever may be imposed upon said releasees because of any defect in or lack of such capacity to so act and release said releasees on behalf of both myself and the aforementioned minor. Also, I hereby consent that any photographs which may be taken by the photographer may be used for the purposes set forth above, signed by the minor, with the same force and effect as if executed by me.

 I have read and I accept the arrangements of the waiver



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After completing your registration and submitting your form, you may proceed to process your payment below.