Registration Form (Under Age 18) — Landry's Cycling Club

NOTE: Use this registration form for riders under the age of 18, to be signed by parent/guardian.

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 an adult (over age 18): Use the adult registration form on this link.

Ride Season/Year

2022 (Register for the whole season)

Rider Info (Under Age 18)

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:

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.)

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

Are you 18 years of age or older?

YES.

NO. If under 18, you must have your parent/guardian sign this release below.

Electronic Signature

I agree to the waiver and release.

Parent / Guardian Acceptance

I attest that I am in fact the parent or legal guardian of the above-named participant. 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 this child's participation in Landry's Group Rides.

PARENT / GUARDIAN: Check the box below to agree to the waiver and release for the above-named child:

Child's Full Name

Parent / Guardian's Full Name

Your Relationship to Child

Parent

Legal Guardian

Parent / Guardian's Phone

Today's Date (mm/dd/yy)

Parent / Guardian's Electronic Signature

I agree to the waiver and release for the above-named child.