Prairie City Race Series Registration

Wed Aug 25 Race Registration
Non-refundable, Non-transferable registration for the August 25 race.
Only register ONCE for the season. After that just show up, pay and race each Wed.
Red fields are REQUIRED

Select Class

Select Shirt Size

Sponsor/Team

First Name

Middle Name

Last Name

Street Address

Street Address 2

City

State

Zip Code

Email Address

Phone
( ) -

Ext.

Age On 12/31/2010

Gender
Male Female

Emergency Contact

Emergency Phone
( ) -

I understand and accept all risk involved with this event and that I could be injured or killed while on this premises or during this activity. In consideration of my entry and of my own free will, I, for myself, my heirs, executors, and administrators, HEREBY FOREVER WAIVE RELEASE DISCHARGE HOLD HARMLESS and agree not to sue, give up any claims, demands, liability damages, costs, and expenses of any kind whatsoever, including personal injuries to me or wrongful death, against Outbound Industries, racemtbikes.com, BicyclingEvents.com, the State of California, property owners, law enforcement agencies, medical staff, it's officials, employees, agents, coordinators, sponsors, volunteers, which may rise, caused in whole or in part by my or others negligence or other fault of the parties or persons. I understand that by signing this document I am releasing any and all parties from any and all liability. I am aware of the potential hazards physical or mental, natural or man made and that there is no medical insurance for this event. Additionally I understand that I may be photographed, video taped or filmed during this event by private persons, news and/or other media and images may be used in commercial or other endeavors by other parties. By checking the waiver box I acknowledge that I have read, accepted and understand this waiver.

I Agree to the terms and conditions of BicyclingEvents.com described above.

I AGREE

Payment Type (Includes $2.25 Processing Fee)

Note: BicyclingEvents.com does not share any private information

Cart Options
This registration form uses a Paypal shopping cart. You DO NOT need a Paypal account to use this form. Step by step instructions are provided below.

Completely fill out the form.

Click Add to Cart. (If paying for more than one racer see TIP below)

Your racer info will be displayed in the Paypal cart.

IF you want to pay for more racers, click Continue Shopping in the Paypal cart.

Finish adding racers, click Proceed to Checkout in the Paypal cart.

Pay with a credit card by selecting Continue link next to "Don't Have a Paypal Account?"

OR Sign into your Paypal account IF you have one.

That's all there is to it. THANK YOU for Registering online! See you at the races.

TIP for easy use!
If you plan to pay with a credit card AND are adding more than yourself to the Cart.
Then add yourself to the Cart LAST and your information will be supplied from the Reg form.