Bike Ride Registration

Step 1

Name:  (Complete one registration for each rider.)
(required)

E-mail Address:  (required)

Phone Number:   (xxx) xxx-xxxx

Address:  

City:  

State:  

Zip:   xxxxx-xxxx

Age:  

Sex: M F

T-shirt Size:
Small Medium Large XL XXL

Ride Option:
Family Fun Ride 26 Mile 40 Mile

Step 1 - Submit registration:

Step 2 - After you click on "submit" a registration email will be sent to William Penn House and you will be redirected to a web page where you can complete your registration by making your donation through Network For Good. When we receive your registration and your contribution, we will send you a confirmation email. Thanks!

On the day of the ride you must complete the following Waiver and Consent:

RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT ("AGREEMENT")
The undersigned do hereby expressly stipulate and agree to indemnify and hold forever harmless William Penn House, its agents, officers, board members and employees, against loss from any and all claims, demands, or actions in law or equity that may at any time be made or brought by the participant listed below, or by anyone on behalf of said participant for the purpose of enforcing a claim for damages on account of any injuries received or sustained by the participant arising out of his/her participation in this program. In signing the Agreement, each of the undersigned hereby acknowledges and represents that they are aware of the risks and hazards inherent in participating in the program, that no insurance covering accident or injury has been provided for participants, and that arrangements for such insurance would have to be made individually by the undersigned.