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Registration Form — Landry's Cycling Club

Please complete and submit this online form to participate in Landry's Group Rides and/or Bike Education classes this year.

All Landry's Cycling Club members must register and submit this online form before participating in Landry's Group Rides or BikeEd classes. Complete one form for each rider participating in Landry's Group Rides/Classes, per year. In addition, see our safety info for group rides.

If you are under age 18:  Use the "under age 18" form on this link, including parent/guardian acceptance.

Ride Season/Year*
2017  (Register for the whole season)


Rider Info  (Adult aged 18 and over)

FIRST Name*
LAST Name*
Street Address*
City/Town*
State*
ZIP Code*
E-Mail Address*
Phone*


Group Ride Selection

Which Landry's Group Rides (or BikeEd class location) would you like to join this year? Check all that apply:

Ride Locations*
Boston
Braintree
Natick
Newton
Norwood
Westboro
Worcester


Emergency Contact

Contact Name*
Relationship*
Contact Phone*


Landry's Cycling Club Waiver and Release

By signing below electronically, I fully understand that I will participate in this FREE ride series at my own risk, and I hereby release Landry's Bicycles Inc. and its directors, officers, past and present employees, ride leaders, volunteers, and participants, and all sponsors from all liability, claims, losses, or damages on my account as a result of my participation. (If under 18 years of age, your parent/guardian must sign.)

Check the box below to agree to the waiver and release:

Are you 18 years of age or older?*
YES.
NO. If under 18, use the "under age 18" registration form (see link at top).
Today's Date (mm/dd/yy)*
Electronic Signature*
I agree to the waiver and release.

Note: * indicates required information.

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