BIKE AROUND LONG ISLAND – 2008

 

Make sure that all information is accurate and complete.

Sign and date the form at the bottom (one person per form, new form each year).

Return the form to George J. Waldbusser, 26 Havemeyer Lane, Commack, NY 11725

OR Bring this form with you on your first trip.

 

NOTE:  Always verify that a trip is on. 

See website for details:  http://www.bikearoundlongisland.com/

 

ALSO – To be on our email list, join our Yahoo group at:

http://sports.groups.yahoo.com/group/BikeAroundLongIsland/

 

First Name:       

 

Last Name:                      

 

Home Phone:  (       )        -

 

Work Phone:   (       )       -

 

Cell Phone:     (       )       -

 

Address:

 

City:                                                                      State:                       Zip:

 

Email:                            

 

Are you a Sierra Club member?     Yes     No           (circle one)

 

Name of emergency contact:                                                      Phone:

 

************************************************************************************************************

PLEASE READ: Bike Around Long Island is not a tour company or business of any kind.  This is an ever-changing group of individuals, joining together for fun.  Trail Boss (a/k/a George J. Waldbusser) only sets the dates and places, and these may change at any time.  These trips are not sponsored by any individual or organization, and no assurance of safety is given.  No mechanical or medical support is provided.  We ride on public streets and hazards include automobile traffic, other cyclists, weather, road conditions, animals, etc. Understand the nature of any trip before starting out.  Be sure that you and your bike are capable of completing a trip.  Helmets are REQUIRED and shatterproof eye protection is strongly recommended for bike rides.  Life jackets should be worn for water activities.  Be aware that in spite of the best of precautions, property can be lost or damaged and people can be injured or killed.  Your participation indicates that you accept the risks and agree to be responsible for your own safety and actions.  You also agree to permit emergency medical treatment in the event that you are injured and are unable to make a decision at the time of the injury.

************************************************************************************************************

 

         

SIGN HERE:  ___________________________________     DATE:  ___________________

 

 

(signupform.htm  4/5/08)