2011 Prairie City Race Series Registration
June 22 Race
Only register ONCE for the season. After that just show up, pay and race each Wed.
No refunds or transfers
All fields are REQUIRED
(except Team/Sponsor)
Class
Pro/Expert
Expert
Sport
Beginner
Beginner Juniors
Single Speed Expert
Single Speed Sport
Single Speed Women
Clydesdale
(Tandem use Walk Up Registration)
Racing Age on 3/30/2011
(Will determine Age Group automatically)
Gender
Male
Female
Shirt Size
Small
Medium
Large
XL
XXL
First Name
Last Name
Mailing Address
City
State
Zip Code
Phone
(
)
-
Email Address
Team/Sponsor
Emergency Contact
Emergency Phone
(
)
-
Waiver
I understand and accept all risk involved with this event and that I could be injured or killed while on this premises or during this activity. In consideration of my entry and of my own free will, I, for myself, my heirs, executors, and administrators, HEREBY FOREVER WAIVE RELEASE DISCHARGE HOLD HARMLESS and agree not to sue, give up any claims, demands, liability damages, costs, and expenses of any kind whatsoever, including personal injuries to me or wrongful death, against Brian Joder, Outbound Industries, racemtb.com, BicyclingEvents.com, TimeYourRace, Ace Course Designs Company, the City of Folsom, State of California, property owners, law enforcement agencies, medical staff, it's officials, employees, agents, coordinators, sponsors, volunteers, which may rise, caused in whole or in part by my or others gross negligence or other fault of the parties or persons. I understand that by signing this document I am releasing any and all parties from any and all liability. I am aware of the potential hazards physical or mental, natural or man-made and that there is no medical insurance for this event. Additionally I understand that I may be photographed, videotaped or filmed during this event by private persons, news and/or other media and images may be used in commercial or other endeavors by other parties.
I have read and agree to the terms and conditions in the above-referenced waiver.
Payment Type
(Includes Processing Fee)
Adult first race $32.50
Junior first race $32.50
Cart Options
This registration form uses a Paypal shopping cart.
You DO NOT need a Paypal account
to use this form.
Step by step instructions are provided below.
Completely fill out this form.
Click "Add to Cart". (If registering for more than one person see below)
Your info will be displayed in the Paypal cart.
If you would like to pay for more runners, click "Continue Shopping".
Finish adding runners info, then click "Proceed to Checkout".
Pay with a credit card by selecting "Continue" next to "Don't Have a Paypal Account?"
OR sign into your Paypal account if you have one.
That's it!
TIP if you are registering more than one person
If you are registering more than one person,
add yourself to the Cart last
and your information will be supplied from the registration form.