9th ANNUAL CHARITY MOTORCYCLE RIDE to benefit the American Cancer Society - Trigg County Relay For Life

Sponsored by the Ms. Fits Relay For Life Team

When: Saturday August 27, 2016

Where: West Cadiz Park - Pavilion (Cadiz, Kentucky) (West end of Cadiz at 139 & Business 68)

Time: Registration begins at 9:30AM

First bike out at 10:00AM Last bike in by 2:00PM

(map of route will be provided)

Cost: $20.00 per bike (includes 1 poker hand, lunch, door prizes,

water & soft drinks

Prizes: Prizes awarded for best and worst hand

Come enjoy a day on your motorcycle touring the beautiful countryside

and support a great cause. Ride is approximately 100 miles.

For more information contact:

Dannye Wagner 270-924-5738 or Kay Wheeler 270-625-4747

REGISTRATION AND WAIVER FORM

For “Riding For A Cure”

9th Annual Charity Motorcycle Ride

Sponsored by the Ms. Fits Relay For Life Team

Saturday August 27, 2016

Rider Name__________________________________________________ Passenger Name_________________________

(If applicable)

Address____________________________________________________________________________________________

City_____________________________________State________________Zip Code_______________________________

Emergency Contact_____________________________________________Phone#________________________________

RELEASE OF LIABILITY AND WAIVER OF CLAIMS

In consideration of my voluntary participation in the above Activity, I hereby accept all risk to my health and of

my injury or death that may result from such participation and I hereby release the above named group, its

members and sponsors from any liability to me, my personal representatives, estate, heirs, next of kin, and

assigns for any and all claims and causes of action for loss or damage to my property that may result from or

occur during my participation in the Activity.

__________________________________ __________________________________

Signature of Participant Signature of Passenger (if applicable)

Date______________________________ Date______________________________