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Online Registration 

Registration/Entry Fees                                                       

Pre-register before September 23- $25 per adult; $10 per child

Register September 23 or later- $30 per adult; $12 per child

* The first 300 registrants receive a free t-shirt and water bottle

There will also be numerous raffle prizes

HELMETS ARE REQUIRED OF ALL RIDERS

NO REFUNDS

In case of inclement weather, call 203.206.6875 or 203.232.3815 after 6:00 AM the day of the event,

or visit the website

The raindate is September 28th, 2008.

The first three hundred registered participants will receive a t-shirt and water bottle. Thank you for supporting the Ride for Rick.

ADULT REGISTRATION


Register an adult online today ! Please note your name or the name of the athlete(s) you are registering and the event in the 'Note to Seller box' on the 'Confirm Your payment ' page.

First Name of Athlete:

Last Name:

Street Address:

City:

State:
  Zip Code:

Telephone:

Email:


Event:



Age (required for awards):


Emergency Contact Name:


Emergency Contact Telephone Number:



Clicking on submit indicates that you accept the Liability and Release below:


Liability and Release

Please note that by registering online you are agreeing to the Rider Assumption of Risk and Release and Waiver of Liability and Claims, and Parental Consent Agreement:

I acknowledge that participation in The Ride for Rick (and/or run) is a potentially hazardous activity.  I will not participate unless I am medically able to do so and am properly trained.  I fully understand and assume full responsibility for the risks associated with participation in this event, including accidental injury, permanent disability, paralysis or death resulting from falls, hazards of vehicular traffic, contact with other riders, contact with traffic along the route, and any other hazards attendant to riding a bicycle or walking on roadways.  I fully accept and assume all such risks and all responsibility for losses, costs, and damages I incur as a result of my participation or that of the minor in the activity.    I hereby release, discharge, and covenant not to sue the Ride for Rick, its respective administrators, directors, agents, officers, members, volunteers, employees, other participants, any sponsors, donors, advertisers, owners and lesser of premises on which the activity takes place, including the Town of Woodbury, the Town of Washington, the Town of Morris, the Town of Bethlehem, and the State of Connecticut (each considered one of the “releasees” herein) from all liability, claims, demands, losses or damages on my account caused or alleged to be caused in whole or in part by the negligence of the “releasees” or otherwise, including negligent rescue operations.  I further agree that if, despite this release and waiver of liability, assumption of risk and indemnity agreement I, or anyone on my behalf, makes a claim against any of the releasees, I will defend, indemnify, save, and hold harmless each of the releasees from any suit, claim, litigation expenses, attorney fees, loss, liability, damage, or cost which any may incur as the result of such claim. 

I have read this agreement, fully understand its terms, understand that I have given up substantial rights by signing it, and have signed it freely and without inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law, and agree that if any portion of this agreement is held to be invalid, the balance, notwithstanding, shall continue in its full force and effect.



CHILDREN'S REGISTRATION


Register a child online today ! Please note the name of the child athlete(s) you are registering in the 'Note to Seller box' on the 'Confirm Your payment ' page.

First Name of Athlete:

Last Name:

Street Address:

City:

State:
  Zip Code:

Telephone:

Email:


Event:



Age (required for awards):


Emergency Contact Name:


Emergency Contact Telephone Number:



Clicking on submit indicates that you accept the Liability and Release below:


Liability and Release

Please note that by registering online you are agreeing to the Rider Assumption of Risk and Release and Waiver of Liability and Claims, and Parental Consent Agreement:

I acknowledge that participation in The Ride for Rick (and/or run) is a potentially hazardous activity.  I will not participate unless I am medically able to do so and am properly trained.  I fully understand and assume full responsibility for the risks associated with participation in this event, including accidental injury, permanent disability, paralysis or death resulting from falls, hazards of vehicular traffic, contact with other riders, contact with traffic along the route, and any other hazards attendant to riding a bicycle or walking on roadways.  I fully accept and assume all such risks and all responsibility for losses, costs, and damages I incur as a result of my participation or that of the minor in the activity.    I hereby release, discharge, and covenant not to sue the Ride for Rick, its respective administrators, directors, agents, officers, members, volunteers, employees, other participants, any sponsors, donors, advertisers, owners and lesser of premises on which the activity takes place, including the Town of Woodbury, the Town of Washington, the Town of Morris, the Town of Bethlehem, and the State of Connecticut (each considered one of the “releasees” herein) from all liability, claims, demands, losses or damages on my account caused or alleged to be caused in whole or in part by the negligence of the “releasees” or otherwise, including negligent rescue operations.  I further agree that if, despite this release and waiver of liability, assumption of risk and indemnity agreement I, or anyone on my behalf, makes a claim against any of the releasees, I will defend, indemnify, save, and hold harmless each of the releasees from any suit, claim, litigation expenses, attorney fees, loss, liability, damage, or cost which any may incur as the result of such claim. 

I have read this agreement, fully understand its terms, understand that I have given up substantial rights by signing it, and have signed it freely and without inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law, and agree that if any portion of this agreement is held to be invalid, the balance, notwithstanding, shall continue in its full force and effect.

If you wish to download the registration, click here.

Then please return the form along with your payment to: 
The Ride for Rick
C/O Pam Peck
P.O. Box 1092
Woodbury, CT 06798