EmailMe Form - Bike Around Long Island Sign-Up Form

Bike Around Long Island Sign-Up Form
(A new form is required each year for each person)

Name *

First

Last

Home Phone Number

###

####

Cell Phone Number

###

####

Address *

Street Address
Address Line 2
City	State / Province / Region
Postal / Zip Code	Country

Email

Email address must be valid

Confirm

Emergency Contact Name *

First

Last

Emergency Contact Phone Number *

###

####

Image Verification
	Please enter the text from the image: [Refresh Image] [What's This?]

PLEASE READ: Bike Around Long Island is not a tour company or business of any kind. This is an ever-changing group of individuals, joining together for fun. Trail Boss (a/k/a George J. Waldbusser) only sets the dates and places, and these may change at any time. These trips are not sponsored by any individual or organization, and no assurance of safety is given. No mechanical or medical support is provided. We ride on public streets and hazards include automobile traffic, other cyclists, weather, road conditions, animals, etc. Understand the nature of any trip before starting out. Be sure that you and your bike are capable of completing a trip. Helmets are REQUIRED and shatterproof eye protection is strongly recommended for bike rides. Life jackets should be worn for water activities. Be aware that in spite of the best of precautions, property can be lost or damaged and people can be injured or killed. Your participation indicates that you accept the risks and agree to be responsible for your own safety and actions. You also agree to permit emergency medical treatment in the event that you are injured and are unable to make a decision at the time of the injury.

EMF HTML Form Builder
Report Abuse