Fort Davis Cyclefest     September 20th - 21st, 2003
Tour Entry Form
Please Print Clearly 

Name:_____________________________________Address:_____________________________________ 

City, State, Zip:____________________________________________________________________ 

Phone:________________________ Age:_______email:____________________________ 
_____I would appreciate receiving future info by email 

Emergency, Notify_______________________________Phone________________________ 

T Shirt Size  S____M____L____XL_____XXL_____  Distance you will ride (please circle)  10Mi  25Mi  50Mi  75Mi
I would like to volunteer during the tour (Name)___________________________________________________ 

Registration Fees:
Early Registration Until Sept. 5:
(includes T-Shirt)  $25.00 .   .   .    .   .   .   .   .   .    .   .   .   .   .   .    .   .   .   .   .   .   _________ 
Late Registration after Sept. 5:
(T-Shirt not included) $25.00 .   .   .   .    .   .   .   .   .   .    .   .   .   .   .   .    .   .   .   . _________ 

Saturday Night Spaghetti Meal: $10.00 .    .   .       .   .   .    .   .   .   .   .   .    .   .   .   .   _________

                   Children under 10 $5.00   .    .   .   .   .   .   .   .   .   .   .   .   .    .   .   .   .    _________ 

Mount Locke Hill Climb: $1.00  1.5 Mi____ 7Mi____  .   .  .   .   .   .   .   .   .   .    .   .   .   _________ 

Extra T-Shirts: $15.00 S___ M___ L___ XL___ XXL___     .   .    .   .   .   .   .   .   .   .   .  _________ 

Grand Total This Registration  (NO REFUNDS) .   .   .   .   .   .    .    .   .   .   .   .   .   .   . _______

CPSC or Similarly approved helmet required

Please read the following carefully - You are agreeing to Release, Defend, Indemnify, and Hold Harmless the PBBA and Cyclefest Sponsors.
I understand that bicycle riding carries with it, under all conditions, certain dangers and risks to my safety that I agree to assume. 

In consideration of my participation Cyclefest, the undersigned (for myself, my heirs, administrators, and executors) agrees to release, defend, indemnify, and hold harmless the Permian Basin Bicycle Association and its officers, members, employees, sponsors, insurers, and attorneys as well as all sponsors of Cyclefest (collectively “PBBA”), from any and all claims, suits, demands and causes of action of any kind or nature which arise from, relate to, or have any connection with the undersigned’s participation in Cyclefest. This agreement shall be effective regardless of the theory of liability against the PBBA, including, but not limited to, the SOLE, JOINT, OR CONCURRENT NEGLIGENCE, GROSS NEGLIGENCE, INTENTIONAL CONDUCT OF PBBA, liability based on any statute or government regulation, and strict liability; and as to all damages, including, but not limited to, compensatory damages, special damages, consequential damages, exemplary damages, and damages based on any statute or government regulation or attorney fees.   

Rider’s Signature:______________________________________Today's date: ___________________

Parent or Guardian(if under 18) :____________________________________________
Make Checks Payable to:   Permian Basin Bicycle Association (P.B.B.A.)            Mail to:          P.B.B.A.
                                                                                                                                            4712 N. Midkiff Rd.
                                                                                                                                            Midland, TX 79705