Ride Pre-Registration

Rider

First Name *

Last Name *

Address *

City *

State *

Zip *

Phone

Medical Issues

Emergency Contact - Relationship

Will you have a passenger *

Passenger

First Name *

Last Name *

Address *

City *

State *

Zip *

Phone

Medical Issues

Emergency Contact - Relationship

Waiver

By signing below I herby acknowledge and accept the inherent risks involved in motorcycle riding activities and agree to indemnify and hold American Legion Riders 781, American Legion and Valor Clinic it's employees, agents, volunteers and assigns harmless against ant and all claims of injury, loss or other claim of whatever nature that may in anyway arise out of my participation in the charity ride or its attendant activities.

Rider Signature *

Passenger Signature *

By typing your name, you are digitally signing the waiver