Tour de Muleshoe

Saturday, June 17, 2017

Ride Application and Release

 

***Please note the start time for 2017 is 8:00 am***

 

 

Complete Application, sign waiver below, and mail with your entry fee check payable to the Muleshoe Heritage Center, P.O. Box 201, Muleshoe, Texas 79347. Phone: (806) 272-5873 or (806) 272-3487

 

Last Name: ____________________________ First Name: _______________________Sex: _________

Address: _______________________________________________________________ Age: _________

City: ____________________________________ State: _____________________ Zip: _____________

Home Phone: (______)___________________ in case of emergency: (______) ____________________

Check Category: ___ 100k Ride ___ 40 Mile Ride ___ 10 Mile Ride Any Ride: $30 per person, $______

Spaghetti Dinner: (one ticket FREE with application)          Extra Tickets: $5 each,  $______

2017 Tour de Muleshoe T-shirt:       _____S        _____M        _____L        _____XL        _____ XXL

 

 

Waver and Release (Please read and sign below)

Assumption of all risks by the entrant: With the full knowledge and appreciation that bicycle riding is a hazardous activity and in consideration of your accepting this entry, I, intending to be legally bound, for my self, my heirs, executors and administrators, waive and release any and all rights of claim for damages as I may have against the Tour de Muleshoe organizers, their agents and the towns, counties, and state in which the tour is run, their representatives, successors, and assign, and for any and all injuries and/or property damages suffered by me in said event; and for the same consideration, the undersigned parent or guardian hereby indemnifies and agrees to hold the Tour de Muleshoe organizers, and their agents, harmless from any and all liabilities which may occur by the entry of the applicant in the Tour de Muleshoe.

 

 

Signature of Entrant _____________________________Date___________

(All participants must sign. Parent or guardian must sign for person under 18 years of age.)