Registration Form for Stewart State Forest Bike Tour, Event Date: June 8th, 2008
(Please print out form and fill in legible)

Name _____________________________________________________________

Address ___________________________________________________________

City ___________________________ State ____________ Zip ____________

Phone Number ______________________ E-mail___________________________

Age __________

___ $25-Pre-Registration  ___$30-Day of Tour

___ $15-Child (under 14)

___ $55-Family Rate ___ $60-Day of Tour

___ 18 miles ___ 16 miles ___ 9 miles

Pre-register by June 4th for FREE T-shirt
T-shirt preference:___ Large  ___Medium ___ X-Large

In consideration of my accepting this ride application, I hereby for myself, my heirs, next of kin, executors, administrators, and assigns, release and absolve any and all organizers, officers, volunteers, members, and participants from and against any negligence, fault, blame or liability, for any injury, harm, misadventure, loss of damage suffered as a result of my participation in this event. I further understand that helmets are required to be worn, and any injury suffered by the omittance of safety-approved helmets is strictly my fault, and I consider myself to be duly warned. I also certify that I am in good physical condition and am able to handle the rigors of this ride,

Signature: __________________________________ Date:______________

Signature of parent or guardian if under 18

_________________________________________ Date: ____________

Make checks payable to: SPARC

Mail check and entry form to:

Stewart Buffer Bike Tour, P.O. Box 90, Blooming Grove, NY 10914

Contact: Ralph Grimaldi (845) 496-9487, fax (845) 564-3018

Email: sparc@frontiernet.net