REGISTRATION FORM ( one application per rider) SIGNED RELEASE REQUIRED

          In consideration of the acceptance of this entry and by signing this Release for myself (or for the participant if under 18) I agree to RELEASE, HOLD HARMLESS, AND INDEMNIFY Emerald City Lights Bike Ride and all sponsors, advertisers, owners, and lesser of premises on which the activity takes place, their respective officers, agents and members, and any other parties connected or any activity associated with  the Emerald City Lights Bike Ride event for any injury, loss or damage suffered as a result of participation in the Emerald City Lights Bike Ride event caused by the Negligence of any party.

          I understand that there are certain risks associated with bicycle riding, including the risk of serious personal injury or death, and I expressly agree to assume those risks.  I warrant that I am in proper physical condition to participate in this event, that I am a sufficiently competent cyclist to handle the road conditions and that my bicycle is in safe operating condition.

          I understand that this Release is also binding on my heirs and representatives.  If I am signing on behalf of a minor, I accept full responsibility for all medical expenses incurred as a result of the minor's participation.  I agree to HOLD HARMLESS AND INDEMNIFY the entities named above for any claims brought on behalf of the minor.

  I AGREE              Signature ____________________________  Date ____________

Make check or money order payable to Emerald City Lights, PO Box 872, Auburn, WA  98071

After registering with PayPal/Credit Card - Print information Form above and send to email address

E-mail info@emeraldcitylightsbikeride.org or contact us at 253-709-1530 or 253-735-4982

You May Order your Emerald City Lights T-Shirt 

for $10 with Your Registration or at the Event (depending on availability)

Sizes:       S      M      L      XL