2nd Annual Ride for the Memorial
Wisconsin chapter 5
The Wisconsin state Firefighters Memorial in Wisconsin Rapids is one of the most surreal places to visit. There has been a lot of time, money, and effort put into making such a wonderful place. The Red Knights WI chapter 5 has chosen to Honor those who have given the ultimate sacrifice by helping to support the place they will be remembered. Please join us in honoring those who gave all by supporting the Memorial. All proceeds go directly to the Memorial for maintenance, upkeep, and whatever else they need the money for.
The cost is $25.00 for single, and $40.00 for double up. Cost includes T-shirt, food and drinks, as well as a chance to win door prizes. There will also be a 50/50 raffle. Registration will be from 11 am – noon. At the Eagle River fire station 820 E. Pine street Eagle River WI. 54521 Also we will have a fire truck escort from start to finish. For more information please contact Cory @ choffmann@frontiernet.net, or go to www.wsfm.org
Ride for the Memorial
The Wisconsin State Firefighters Memorial
Honoring those who have made the ultimate sacrifice
Red Knights Firefighters Motorcycle Club – Wisconsin Chapter 5
2nd Annual Motorcycle Ride for the Memorial Registration Form
Friday, September 17, 2010
Name of registrant:_________________________________
Name of rider (if applicable):_________________________
Mailing address:___________________________________
___________________________________
___________________________________
Phone number (day):_________________________Phone number (night):____________________________
e-mail address:____________________________________
_____Single Rider Bike @ $25.00:_______________
_____Double-Up Bike @ $40.00: ________________
Amount of check enclosed:________________
Make checks payable to: Red Knights Firefighters MC – WI 5
Mail completed form to: Red Knights Firefighters Motorcycle Club – WI 5
c/o Cory Hoffmann, Sec/Treasurer/Quartermaster
4235 Thunder Ln.
Rhinelander, WI 54501
.
Red Knights Firefighters Motorcycle Club
Ride Waiver Release and Consent
Safety is our primary concern. Please observe all federal, state, and local laws. Ride safely and defensively. We request that you wear a helmet, appropriate clothing and eyewear and that your passenger does the same. If you and/or passenger choose to ride without a helmet, you do so at your own risk. Please ride with your headlight on at ALL times and never ride under the influence of alcohol or drugs.
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NAME OF EVENT: 2009 Ride for the Memorial
DATE: Friday, Sept. 17, 2010
STARTING LOCATION: Eagle River Area Fire Department, 820 E. Pine St., Eagle River, WI
OTHER LOCATIONS: Boulder Junction, St. Germain
ENDING LOCATION: St. Germain Fire Department
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In consideration of the Red Knights Firefighters Motorcycle Club, Inc, Red Knights Firefighters MC – WI 5 and its Fund Raising Committee, and any other of the sponsors of this event, permitting [me] [my child] ________________________________, who is under the age of 18] to participate in the above named event. I hereby, and for [my] [my child's] heirs, executors, administrators, their representatives, and all legal guardians, WAIVE AND RELEASE ANY AND ALL RIGHTS AND CLAIMS OF ANY NATURE FOUNDED IN WHOLE OR IN PART UPON ANY TYPE OF NEGLIGENCE, that [I] [my child] may have against the above parties, its directors, officers, employees, agents, chapters, assignees, licenses, volunteers and any cooperating entities, their representatives, heirs, executors, administrators, successors, and assigns [the "Released Parties"] arising out of or resulting from any and all injuries or damages of any nature, including death which [I] [my child] may suffer while taking part in the event or any activities connected with the event. I UNDERSTAND THAT THIS AGREEMENT MEANS THAT I WILL NOT TO SUE any or all of the Released Parties in connection with the event.
[I AM] [MY CHILD IS] EXPERIENCED IN AND FAMILIAR WITH THE OPERATION OF MOTORCYCLES AND FULLY UNDERSTANDS THE RISKS AND DANGERS INHERENT IN MOTORCYCLING. [I am] [my child is] voluntarily participating in the event and I expressly agree to assume sole responsibility for the safe and successful operation of my motorcycle, and to accept the entire risk of any accidents or personal injury, including death, which [I] [my child] might suffer as a result of my participation in the event. I further understand that [I] [my child] assume all risks in participating in the event.
Consent also is hereby given to use [my] [my child's] name, picture, portrait, likeness, writings or biographical information, and audiotape and/or videotape recordings and sound or silent motion pictures of [me] [my child] in any medium of editorial, educational, promotional, and advertising purposes, for the solicitation of contributions, and/or for any other purposes in furtherance of the corporate purposes and objectives.
By signing this document, I certify that I have read this document and fully understand it, and that I am not relying on any statement or representations of any of the Released Parties. This document shall be binding upon me, my [my child's] heirs executors, administrators, and assigns [and all legal guardians of my child].
______________________________________________________________________________
Print Name of Rider Print Name of Passenger
______________________________________________________________________________
Home Address Home Address
______________________________________________________________________________
City, Sate & Zip Code City, Sate & Zip Code
______________________________________________________________________________
Phone Number Phone Number
E-mail Address ______________________________________________________________
______________________________________________________________________________
Signature of Rider Signature of Passenger
______________________________________________________________________________
Signature of Parent/Legal Guardian if Rider is Under 18
http://titancast.titantv.com/p/wjfw/s/Red-Knights-Fundraiser/1ACA1FHE.aspx
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