The TELUS Motorcycle Ride For Dad REGISTRATION FORM

 I have registered online (if you have cash/cheque pledges, please complete this form and bring it, along with your additional pledges, to the Express Registration line on Ride Day) Name: Gender: Male Female Address: City: Phone (Home): Im riding with Team/Club: Vehicle Manufacturer: Email: Birth Year:
Address:

The TELUS Motorcycle Ride For Dad PledGe FORM

All pledges must be collected and submitted before the Ride begins. Receipts will be issued for donations of $20 or more, provided name and address are complete and legible. Make all cheques payable to Ride For Dad. Working in partnership with the Prostate Cancer Fight Foundation, charitable registration #851333179RR0001. Amount
Donor Name: Tel: Floor/Apt. # Tel: Floor/Apt. # Tel: Floor/Apt. # Tel: Floor/Apt. # Tel: Floor/Apt. # Tel: Floor/Apt. # Tel: Floor/Apt. # Tel: Floor/Apt. # Tel: Floor/Apt. # Tel: Floor/Apt. # Email: City Email: City Email: City Email: City Email: City Email: City Email: City Email: City Email: City Email: City Postal Code Postal Code Postal Code Postal Code Postal Code Postal Code Postal Code Postal Code Postal Code Postal Code

Captains Club # (if applicable):

Address: Donor Name: Address:

Prov: (Work):

Postal Code:
Donor Name: Address: Donor Name: Address: Donor Name:

Id like to make a personal pledge towards my fundraising goal: $ Are you aliated with TELUS? Employee Customer How did you hear about the Ride? Television Radio Print Friend Dealership Other Please add my name to the MRFD E-news distribution list.  YES I have a valid motorcycle license, approved helmet and insurance required to participate. WAIVER
I understand and am aware that there are dangers and risks involved in riding a motorcycle, and in riding a motorcycle in a group such as The TELUS Motorcycle Ride For Dad. These dangers and risks include damage, injury, serious injury and/or death. Knowing and appreciating fully these dangers and risks, I the undersigned, hereby waive, release and forever discharge The TELUS Motorcycle Ride For Dad, the proceed recipient, the police, members of the organizing committee, sponsors, supporters, volunteers and all other associates with the event of and from all manner of actions, causes of action, suits, debts, claims and demands whatsoever arising from or in connection with The TELUS Motorcycle Ride For Dad and associated events. I assume full responsibility for injury or damage arising as a result of the participation association with The TELUS Motorcycle Ride For Dad event and for my passengers. This waiver also includes a model release for photographs taken and audio/video recordings made while participating in the above activities.

Donor Name: Address: Donor Name: Address: Donor Name: Address: Donor Name: Address: Donor Name: Address:

Registration is $30 or FrEE with $100 or more in pledges. For registration dates, times and locations, go to RideForDad.ca. Passengers must register to participate in ride activities, prize draws and meals. There is no charge for passengers who do not. PLEASE PHOTOCOPY THIS PAGE FOR ADDITIONAL PLEDGES.

Total Pledges My Personal Pledge Registration Fee Total (this page only) Total All Pages

Signed: Date: