2010 AORTA Registration Form

2017 AORTA Registration Form

Please fill out the attached registration form and waiver and return with full payment by May 1st, 2017. No refunds after May 1st, 2017. There will be a VERY limited number of spaces available for walk-ins, so please register now to assure your place in the festivities.

Team Name: ______We ride a:______

Captain Name: ______

Stoker Name: ______

Mailing Address: ______

City:______State:______Zip Code: ______

Home/Office Phone: ______Cell Phone: ______

Email: ______T-shirt sizes S___M___L___XL___

Offsite Emergency Contact Name & Phone:______

Combined Team Age*: ______Years Riding Tandems: ______

Preferred Ride Level and Team Skill/Fitness level (for ride classification only):

______Easy/Beginner ______Moderate/Intermediate ______Advanced/Difficult

List any food allergies or dietary requests (vegetarian, etc.):______

Any other special needs? (Please describe) ______

* (For statistical purposes only; individual ages will not be published)

Fees. The fee for each participating rider for the entire weekend is $80.00. This covers a Friday night Spaghetti/Pasta supper and social, Saturday and Sunday trail rides, sack/picnic lunch on Saturday, BBQ dinner on Saturday night, and sack/picnic lunch on Sunday. Bottled water will be provided throughout the weekend; other beverages are available onsite; BYOB if you prefer.

All registered teams will receive maps, swag bags, snacks, and other goodies.

All events will take place rain or shine, but activities may be altered in event of inclement weather. Because the fee is all-inclusive, there can be no discount for missing any of the events. Accommodations and lodging expenses are on your own; this registration fee does not cover any lodging or other accommodations.

Total number of riders______x $80.00 = ______

Payment Options. Please send a check with your completed and signed registration form to:

MTB Tandems

Attn: Alex Nutt

221 Rope Mill Parkway Suite 2

Woodstock GA 30188.

We suggest Priority Mail, FedEx Ground or UPS for sending the registration form to limit potential for lost entries.

Completed registration forms can also be faxed to 678-550-1799.

Please make checks payable to MTB Tandems, and please write AORTA 2017 on the reference line.
Credit card payments are also accepted; please call Alex @ 678-445-0711 to provide CC info. We must have your signed registration form in hand to process CC payments.

Please do not send credit card info via mail or email!

Please sign and date the following waiver and include it with your registration form.

RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK

AND INDEMNITY AGREEMENT

IN CONSIDERATION of being permitted to participate in any way in the MTB Tandems, Inc. (hereinafter, MTB) sponsored Bicycling Activity, the Appalachian Off Road Tandem Adventure, (hereinafter, the Activity), for myself, my personal representatives, assigns, heirs, and next of kin:

I ACKNOWLEDGE, agree, and represent that I understand the nature of Bicycling Activities and that I am qualified, in good health, and in proper physical condition to participate in the Activity. I further acknowledge that the Activity will be conducted over public roads and facilities open to the public during the Activity and upon which hazards of traveling are to be expected. I further agree and warrant that if at any time I believe conditions to be unsafe, I will immediately discontinue further participation in the Activity.

I FULLY UNDERSTAND that:

BICYCLING ACTIVITIES INVOLVE RISKS AND DANGERS OF SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS, AND DEATH (hereinafter "RISKS");

B. These Risks and dangers may be caused by my own actions or inactions, the actions or inactions of others participating in the Activity, thecondition in which the Activity takes place, or THE NEGLIGENCE OFTHE "RELEASEES" NAMED BELOW;

C. There may be OTHER RISKSAND SOCIAL AND ECONOMICLOSSES either not known to me or not readily foreseeable at this time,and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALLRESPONSIBILITY FOR THE LOSSES, COSTS AND DAMAGES Iincur as a result of my participation in the Activity.

I HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUEMTB Tandems Inc.,the Event Coordinator, the National Forest Service, their respective administrators, directors, agents, officers, volunteers and employees, other participants, any sponsors, advertisers, and, if applicable, owners and lessorsof premises on which the Activity takes place (each considered one of the “RELEASEES" HEREIN) FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES OR DAMAGES ON MYACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OFTHE "RELEASEES" OR OTHERWISE, INCLUDINGNEGLIGENT RESCUE OPERATIONS; AND I FURTHER AGREEthat if, despite this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT, I, or anyone on my behalf, makes a claim against any of the Releasees, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES from any litigation expenses, attorney fees, loss, liability, damage, or cost which any may incur as the result of such claim.

I FURTHER CERTIFY THAT I AM 18 YEARS OFAGE OR OLDER, HAVE READ ANDUNDERSTAND THE TERMS OF THIS AGREEMENT UNDERSTAND THAT I AM GIVING UP SUBSTANTIAL RIGHTS BYSIGNING THIS AGREEMENT AND HAVESIGNED IT VOLUNTARILYAND WITHOUTANYINDUCEMENT OR AS-SURANCE OFANY NATURE AND INTEND IT TO BEA COMPLETE AND

UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENTALLOWEDBYLAW. I AGREE THATIFANY PORTION OF THISAGREEMENT IS HELD TO BE INVALID, THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT.