Registration

At this time, pre-registration can be submitted below. Entry fees will be due on the day of the event at the registration table prior to starting the event. The below information will be printed on a registration form along with a waiver.

Fees must be paid and waiver signed by all participants prior to participating in the event.

The below information is solely for use by Kickstand Up to Kick Out Cancer for this specific event on March 31, 2018. This information will not be used for any other purpose, nor shall it be disseminated to any parties other than those affiliated with the event and solely for the purpose of registering participants. Example text for the waiver is shown at the bottom of this page. Text is subject to change and should be read on the actual form prior to signing on the day of the event.

About the Bike
Year Make

Model CC

About the Rider About the Passenger
Name:

Address:

City:

E-mail:

State:

Name:

Address:

City:

E-mail:

State:


Extra hand for rider
Extra hand for passenger

By signing this waiver, I acknowledge that I am fully aware of the danger(s) and hazard(s) associated with participating in a motorcycle ride. I certify that I am duly licensed and competent to operate a motorcycle in a safe and responsible manner, and the vehicle is in safe operational condition. I will be riding on public highways and understand that I am solely responsible to determine the speed and operational characteristics of my motorcycle while participating in the run. I hereby release and hold harmless Kickstands Up to Kick Out Cancer, The Westin, Cure Childhood Cancer, and any of its members, affiliates, sponsors, or stop locations against any and all claims, causes of action, and/or any other liability of any kind arising from my participation and activity affiliated with this specific ride. I agree to hold harmless those establishments affiliated with this run, during this run, and accept full and sole responsibility for my own actions. I certify that I have no known physical or mental impairment that may affect my safety or the safety of other participants. I understand and acknowledge that the choice of wearing a helmet and/or other protective gear is solely my choice and I am responsible for my compliance with all state laws, including those regarding helmets. I certify that I am not under the influence of any narcotic, alcohol or other substance that may impair my understanding or judgment and that I will not at any time during this ride operate my motorcycle under the influence of any narcotic, alcohol beyond legal limit, or other substance that may impair me. I also understand that this Waiver and Release is in force from the date of signature through the completion of the event and covers any and all activities affiliated with Kickstands Up to Kick Out Cancer and/or this event.