"CYCLING FOR A CAUSE" Registration Form

Welcome to the "CYCLING FOR A CAUSE" registration page. This is the first cycling event in McDonald County that starts and ends in McDonald County. This first of a kind event is designed to help raise awareness of many of the non-profits in McDonald County, as well as introduce cycling in general to those that may not have been exposed. Cycling is one of the healthiest and family-centered activities one can choose - why not do it in McDonald County?

NOTE: Anyone 17 and under must have a parent or guardian complete and sign this registration form.

Full Name

Physical Address

Phone Number Where Cyclist Can Receive Texts

Date of Birth

Age

Gender

Male

Female

Emergency Contact

Emergency Contact Phone Number

"PEDAL IT FORWARD" has agreed to donate a limited number of bikes to those in need of a bike. These are yours to keep. We ask due to the limited supply that only those without bikes check the box below. We want to thank "PEDAL IT FORWARD" for this generous donation to a healthy lifestyle in McDonald County.

Are You in Need of Bike in Order to Participate In This Event?

Height (Only Respond if Above Box is Checked)

Weight (Only Respond if Above Box is Checked)

EVERY dollar of the registration fee (minus cost of awards) goes directly to a local non-profit. You can pay the $59 registration fee OR you can commit to obtain pledges for each mile you ride. The next two boxes are critical in selecting your options.

Select the Local Non-Profit You Are Cycling To Support

Are Paying a One-Time $59 Registration Fee OR Obtaining Pledges

Select Your Cycling Distance

EVENT NOTES: I understand that this is a ride focused on health, family fun, and enjoyment, this is not a competitive race. I agree to obey all the rules of the road and act in the safest manner possible at all times. Additionally, in the event of a weather cancellation, I understand that any registration fees paid will be used towards next years event.

I certify that I am 18 or older OR parent/guadian of the above cyclist.

Click Link For Wavier

https://www.mcdonaldcountychamber.org/cycling-for-a-cause-waiver/

I certify that I have read and agree to the Assumption of Risk, Waiver of all Liability, and Indemnification Agreement for Cycling for a Cause.

Signature (Type Full Legal Name)

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