The Imagination Ride Registration Form

IMAGINATION RIDE REGISTRATION FORM

Please fill out the form below to register

I Agree To The Terms & Conditions Of This Event 

I agree that bicycling is a potentially hazardous activity and that serious injuries or death can occur from accidents, negligence or carelessness. I am in good health and proper physical condition to participate in the ride. I agree that route markings and maps are provided for my convenience only and not to guarantee a safe route or trip. I voluntarily participate in this event and assume all risks associated with participating in this event, including, but not limited to, illness, injury, falls, contact with participants, effects of weather, traffic and conditions of the road, all such risks being known and appreciated by me. I will obey all laws, ordinances and regulations and will do my best to make this ride fun and safe for everyone. Having read this waiver and knowing these facts and in consideration of your accepting my registration, I, for myself and for those upon whose behalf I act, waive and release the United Way of Northwest Illinois, Inc. against any and all claims, suits, or actions of any kind whatsoever for liability, damages, or compensation. I expressly agree to release and discharge United Way of Northwest Illinois, Inc. and their staff, volunteers, and affiliates, from any and all claims or causes of action and I agree to voluntarily give up or waive any right that I otherwise have to bring a legal action against United Way of Northwest Illinois, Inc. for personal injury or property damage. If I am the parent and/or legal guardian of a minor participant, I certify that the minor is in good health, qualified and in proper physical condition to participate in the ride and I hereby release, discharge, covenant not to sue, and agree to indemnify and save and hold harmless all of the above released parties from liability, claims, demands, losses or damages on the minor's account incurred in connection with the ride or its related events and activities. I will indemnify, save and hold harmless each of the released parties from any litigation expenses, attorney fees, loss, liability, damage or cost that may occur as the result of any such claims in connection with the minor's participation in the ride and its related events and activities. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose. I agree to wear a helmet during this ride.
 
Sign above
Choose your Riding Level
The Imagination Ride has a level for everyone!
How many miles would you like to complete during the Imagination Ride event, September 5-September 30, 2020?
Get your friends & family involved! Ask them to sponsor your Imagination Ride, by donating in your name
Do you need to add another rider?
Additional Riders Information
18 + 1 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.