Individual Cyclist Registration Form

2008 Registration is closed.  Check back in the spring for 2009 information.

Complete the registration form below to enter as an INDIVIDUAL PARTICIPANT in the
50,000 Mile Commuter Challenge!

Be sure to encourage your EMPLOYER or SCHOOL to sign up as an EMPLOYER!

DEADLINE to register is Friday, May 16th.

* Indicates Required Field

 HOME INFORMATION  WORK/SCHOOL INFORMATION
* Name:  Employer/Institution: 
*Address:  Address: 
*City: City:
*Zip Code: Zip Code:
*Home Phone: Work Phone:
 

*Email:


(Check this box) Yes, I want to join in taking the 50,000 Mile Challenge. I pledge to bike at least once during May 12-18th, to help reduce carbon emissions, save gas, and save money.
Number of days
you plan to Bike during Bike Week
Number of round-trip miles
you plan to commute
each day by bike
Total Miles Pledged
X =

I am planning to participate in the following activities (click here for more information):

Safe-Rider Convoy
Breakfast Pit Stop
Goodie Zone
Bike Buddy (Recruit your own buddy to try biking with you, or email us
to request a match for someone in your area.)
 
Check here if you would like to receive more information from BSBW organizers
(MassBike, TMAs, City of Boston, City of Cambridge).

By checking the box below, I agree to the following statement:

Individual Registration Form Liability Agreement (Rev 3/10/08)

I ACKNOWLEDGE THAT BY CLICKING "YES, I AGREE" BELOW, I AM ASSUMING RISKS, AND AGREEING TO INDEMNIFY, NOT TO SUE AND RELEASE FROM LIABILITY THE ORGANIZERS OF THESE EVENTS AND THAT I AM GIVING UP SUBSTANTIAL LEGAL RIGHTS. THIS ENTRY BLANK AND RELEASE IS A CONTRACT WITH LEGAL AND BINDING CONSEQUENCES AND IT APPLIES TO ALL EVENTS AND ACTIVITIES ENTERED AT THE EVENT, REGARDLESS WHETHER OR NOT LISTED ABOVE. I HAVE READ IT CAREFULLY BEFORE SIGNING, AND I UNDERSTAND WHAT IT MEANS AND WHAT I AM AGREEING TO BY SIGNING.

In consideration of the issuance of a license to me by one or more Releasees or the acceptance of my application for entry in the above event, I hereby freely agree to and make the following contractual representations and agreements. I ACKNOWLEDGE THAT CYCLING IS AN INHERENTLY DANGEROUS SPORT AND FULLY REALIZE THE DANGERS OF PARTICIPATING IN THESE EVENTS, whether as a rider, mechanic, volunteer, or otherwise, and FULLY ASSUME THE RISKS ASSOCIATED WITH SUCH PARTICIPATION INCLUDING, by way of example, and not limitation: the dangers of collision with pedestrians, vehicles, other riders, and fixed or moving objects; the dangers arising from surface hazards, including pot holes, equipment failure, inadequate safety equipment, use of equipment or materials provided by the event organizer and others, THE RELEASEES' OWN NEGLIGENCE, the negligence of others and weather conditions; and the possibility of serious physical and/or mental trauma or injury, or death associated with the event. For myself, my heirs, executors, administrators, legal representatives, assignees, and successors in interest (collectively "Successors") I HEREBY WAIVE, RELEASE, DISCHARGE, HOLD HARMLESS, AND PROMISE TO INDEMNIFY AND NOT TO SUE the Releasees and all sponsors, organizers and promoting organizations, property owners, law enforcement agencies, public entities, special districts and properties that are in any manner connected with this event, and their respective agents, officials, and employees through or by which the event will be held, (the foregoing are also collectively deemed to be Releasees), FROM ANY AND ALL RIGHTS AND CLAIMS INCLUDING CLAIMS ARISING FROM THE RELEASEES' OWN NEGLIGENCE, which I have or which may hereafter accrue to me and from any and all damages which may be sustained by me directly or indirectly in connection with, or arising out of, my participation in or association with the events, or travel to or return from the events. I agree it is my sole responsibility to be familiar with my commute, route and schedule. I understand and agree that situations may arise during the events which may be beyond the control of the Releasees, and I must continually ride and otherwise participate so as to neither endanger myself nor others. I accept responsibility for the condition and adequacy of my equipment, and equipment provided for my use, and my conduct in connection with these events occurring during Bay State Bike Week. I will wear a helmet that can protect against serious head injury, and assume all responsibility and liability for the selection of such a helmet. I have no physical or medical condition which would endanger myself or others if I participate in this event, or would interfere with my ability to safety participate in this event. I agree, for myself and my successors, that the above representations are contractually binding, and are not mere recitals, and that should I or my successors assert a claim contrary to what I have agreed to in this contract, the claiming party shall be liable for the expenses (including legal fees) incurred by the Releasees in defending the claims. This contract may not be modified orally, and a waiver or modification of any provision shall not be construed as a waiver or modification of any other provision herein or as a consent to any subsequent waiver or modification. I consent to the release by any third party to Releasees and their insurance carriers of my name and medical information that may relate solely to any injury or death I may suffer arising from the event. Every term and provision of this contract is intended to be severable. If any one or more of them is found to be unenforceable or invalid, that shall not affect the other terms and provisions, which shall remain binding and enforceable.

 

YES, I agree.

NO, I do not agree.

 

2008 Registration is closed.  Check back in the spring for 2009 information.

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2008 Bay State Bike Week Sponsors

  
2008 Bay State Bike Week Organizers

 

MassCommute (c/o Charles River TMA) | 238 Main Street, Suite 306 | Cambridge, MA 02142 | Tel. (617) 918-4456