Spokane Bicycle Club 2005 Midsummer Nightmare - July 2, 2005

RIDE APPLICATION

Fill out on screen, print, and mail with payment to address below

Do not mail after June 15th. Late entrants should bring this completed and signed form to the late registration/packet pick-up Friday July 1st, or to the start of the ride. All entries postmarked after June 15th, and all late registrants must include the $10.00 late fee, and will receive their shirts two weeks after the event. Sorry, no refunds

Note: Entry includes long-sleeved, commemmorative shirt made of wicking material and great for layering.

Last Name:

First Name:

Address:

City:

State:

Zip:

Phone:

Email:

Emergency Contact:

Name:

Phone:

Shirt Size:

S M L XLXXL

Estimated Completion Time: hours.

Fees:
Ride Fee:		$40.00
Late Fee after June 15th - $10		$
Nightmare Vets Bonus . Subtract $1 for each previous MSN entry		-$
Total Paid:

Read and sign the release of liability below this form. Send the application, signed waiver and check payable to: Spokane Bicycle Club/ Attn: Sally Phillips - Midsummer Nightmare, P.O. Box 62, Spokane, WA 99210

PRINT THIS PAGE, THEN DOWNLOAD WAIVER AND RELEASE