please complete the registration below.

VISITOR arrival time: 12:30 pm.

A certificate of PARTICIPATION will be provided.

Everyone (Adults and minors) needs to submit a separate sign-up form since each form accounts as a waiver.

Address: Les Myers Park, CT Sherrill Building, 228 Lawndale Ave SE, Concord, NC 28025. Date: 29th March (Saturday)

**We love pets but can only allow service dogs (with a special tag or vest identifying them as service animals) due to health and safety concerns, especially in crowded areas. We appreciate your understanding.

Date

MM

DD

YYYY

Name of the Participant

First Name

Last Name

Email (Adult or Parent email if Minor)

Age

Waiver Mandatory: I acknowledge that my or my minor’s participation in “Ride for a Cause Event” is entirely voluntary and may include a risk of injury. I take liability for any health risks faced during the event. I hereby agree to hold harmless and discharge Breast Cancer Hub and Trials of Color from any of all claims or actions that are in any way connected with my or my minor’s presence or participation in the ride or the use of the community park and resources.

Please Print your Full name (First and Last name), which will be considered as your signature for event registration and consent to the waiver