Bikers Against Breast Cancer, Inc.
Two Wheels, One Love.....

Two Wheels, One Love!

Online Registration

BABC 7th Annual Rollin' For The Ribbon
Online Advanced Ride Registration Form

Please complete the form below. You can submit your payment via paypal at the bottom.  Registration is $20.00/Bike or Vehicle and $10.00 per passenger. Children under 12 - $5.00. Patches are for main vehicle only 

Please read the Hold Harmless Waiver below before you submit this form. If you shoud have any questions call Shelia/Breeze at 973-819-3519.

First Name:
Last Name:
Riding Name, if applicable
Club Name, If applicable:
Address:
City:
State:
Zip Code: (5 digits)
Daytime Phone:
Cell Phone:
Email:
Comments:

Hold Harmless Waiver

I do hereby affirm that I possess a legal license or permit to ride/operate a motorcycle/motor vehicle on a public road and; the motorcycle/motor vehicle I am riding/driving is registered and roadworthy.  I agree not to ride in a reckless or dangerous manner and I will comply with any and all traffic and road laws in and of the state of New York.  I am entering the Bikers Against Breast Cancer Run/Ride entirely at my own risk.  I do so, with full knowledge that motorcycling and/or the operation of a motor vehicle are potentially dangerous and that any and all injuries, including accidental death or dismemberment, I may sustain while participating in this Run/Ride shall be at my own risk and responsibility. My family and I  hereby indemnify and hold harmless Bikers Against Breast Cancer, Inc.  their Board, members, agents, representatives, volunteers, all vendors, sponsors, all Essex county, New Jersey’s administration, police departments, all political parties, and all unidentified parties participating in or associated with the Run/Ride from all legal liability from injury or death that may arise either directly or indirectly from the /Run/Ride including any claim of negligence caused by any of the same.  I make this agreement with all individuals, groups or clubs associated with the Bikers Against Breast Cancer Run/Ride.  I further affirm that I do not have any physical, mental, or medical conditions, nor will I consume any alcohol or any other controlled substance, which may impair my ability to operate safely, a motorcycle or motor vehicle. I fully accept and understand this agreement and by submitting it,  I recognize it as a true and binding document. The event date is Saturday, May 12, 2012.

If you do not accept or agree with the terms of this waiver, please DO NOT submit this form

 

 

 

 

 

 

 

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