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2008 HOT Tamale Registration
Text Box: PAYMENT: (One cyclist per application please) Part 1: Ride cost excluding shirt: Before May 23rd: Adult $10 _____ Child (11 to 17) $7 _____ Child 10 & under free _____ After May 23rd: Adult $12 _____ Child (11 to 17) $12 _____ Child 10 and under free _____ Subtotal (ride cost) $ _____ (max $40/family) Part 2: Optional T-Shirt (order by 5/23) T-Shirt: $13 ($15 if XXL) _____ Size □Child Med □Child Large □Adult Small □Adult Med □Adult Lg □Adult XL □Adult XXL (add $2) Subtotal (shirt cost) $ _____ Part 3: Optional donation to Marion County's future rail-trails. The Marion County Park District hopes to develop two rail-trail bicycle paths. One will go west of Marion, while the other would go south to Prospect, connecting with a trail in Delaware County. We've been awarded over $430,000 in grants, but need to raise funds for a 20 to 25% local match. The Heart of Ohio Tailwinds will donate $1 to this effort for each HOT TAMALE rider. We invite you to add your own optional donation here. If you would like your extra donation to be tax-deductible, please attach a separate check for the donation portion, payable to "Prairie Parks Foundation". Please write on the check that this is specifically for "bike trail development" or "bike projects". Subtotal (optional donation for bike trails) $ _____ Total (ride, shirt, and optional donation) payable to "Heart of Ohio Tailwinds" $ _____ Text Box: In signing this release for myself or the named entrant, if entrant is under the age of eighteen (18) years. I acknowledge that I understand the intent hereof, and hereby agree to and will absolve and hold harmless the Heart of Ohio Tailwinds Bicycle Club, The Village of Waldo, and their officials and members, respectively, and any other parties, including any municipalities on route, connected with this event in anyway whatsoever, singly and collectively, from and against any blame of liability for any injury, misadventure, harm, loss, inconvenience, or damage suffered or sustained as a result of participation in the HOT TAMALE ride or in any activities associated herewith. I also hereby consent to and permit emergency treatment in the event of injury or illness. I shall abide by traffic laws and regulations and practice courtesy and safety in cycling. I will sign a League of American Bicyclists Liability release on the day of ride. ENTRANT'S SIGNATURE ____________________________________ DATE _________ (Signature of Parent or Guardian if entrant is under age 18) WE REQUIRE EVERYONE TO USE HELMETS FOR SAFETY Mail to: HEART OF OHIO TAILWINDS, PO BOX 176, MARION, OH , 43301-0176 Text Box: NAME___________________________________ADDRESS______________________________________ CITY_____________________ STATE_____ ZIP___________ PHONE: ( ) _________________ E-mail: ___________________________________ Planned distance? □ 62 □ 34 □ 16 □ 8 Age □ 10 and under □ 11 to 17 □ 18 or older