Tour de Togo 2012
Rider
Registration
Please submit one registration for each rider.
*
Denotes required information.
*
First name:
*
Last name:
*
Password:
*
Password Confirm:
*
Email Address:
.
Street:
City:
State:
Zip:
Phone:
Church you attend:
.
.
Jersey (
Sizing Chart
):
S,
M,
L,
XL,
2XL ,
3XL
Recruited By (if a rookie):
Participation:
Friday
Saturday
Sunday
Accom. Thursday ():
Host Home
Hotel
Not Applicable
Accom. Friday ():
Other
Hotel
Tenting
Accom. Saturday ():
Host Home
Hotel
Not Applicable
.
.
Do you have a Vehicle the tour may use? Describe seating, bike racks, etc.
Comments/Questions:
*
ACKNOWLEGEMENT:
I acknowledge and assume all risks associated with this event including, without limitation, falls, animal bites, food poisoning, accidental needle sticks, effects of weather, including heat and humidity, traffic, road and ground conditions. I have read and fully understand this waiver and in consideration of the acceptance of my entry, for myself and anyone legally acting on my behalf. I waive and release Flaming Pine Youth Camp, Tour de Togo, its directors, officers, volunteers, agents, successors and assigns, and all sponsors, from any and all claims, liabilities or causes of action including without limitation, death, bodily injury, property damage, or any other loss, damage or any inconvenience whatsoever, arising from my participation in this event.
*
Please Initial acceptance
*
For Security, please answer: Who is featured on this year's ride logo?
(Answer: BOB )
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