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Registration Continued
Riding on a Team: Y / N
Team Captain/Team Name: _______________________
How did you hear about Bike 4BGC?Work Facebook Family/Friend
Radio Newspaper Website
TV At BGC Other:______________
Payment Method:Grand Total (from reverse side): $ ___________
Cash payment enclosedCheck enclosed payable to Boys & Girls Club of Portage CountyRegister online at www.bgclubpc.org/bike4bgcPlease charge the credit card listed below
Free entry with business sponsorship / Business name : ______________________
Type of Card (circle): VISA MasterCard Discover American Express
Name on Card: ___________________________________ Exp. Date: ____/_____Card No: _________________________________________ CVV #: _____________Signature: ________________________________________ Date: ______________
Forms and Payment can be returned to: Boys & Girls Club of Portage County P.O. Box 171 Stevens Point, WI 54481
I know that participation in the Bike 4BGC Event could potentially cause injury. I should not enter unless I am medically able and properly trained. I realize that weather, road, and traffic conditions may make this a challenging ride, and I am sufficiently competent at bicycling to handle such conditions found on the planned course. My bicycle is in safe operating condition and I understand that wearing a helmet is mandatory to participate in this event. Understanding the foregoing and in consideration to you accepting my entry, I, my heirs, my personal representative or anyone entitled to act on my behalf hereby release and discharge event officials, sponsors of the event, their agents, representatives and successors from all claims or liabilities of any kind or nature resulting from, or arising out of, or incidental to my participation in this event, even though that liability may arise out of negligence or carelessness on the part of the entities named herein. In addition, I grant permission to all of the entities named herein photographs, videos, or any other record of this event for any legitimate purpose. I represent that I am of lawful age and legally competent to execute this statement and that before proceeding, I have read and understand its content completely.
Waiver and Disclaimers:
Signature: ____________________________________ Date: ______________P.
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RIDE DISTANCES: 60 mile, 20 mile, 13 mile, 8 mile, & the 4 Mile Rich Johnson Family Ride/Walk
SaturdayAugust 3rd, 2019
Start & Finish located at AIG TRAVEL3300 Business Park Drive / Stevens Point, WI 54482
Participant Name:__________________________________________ M / F Age:_____ Length (Mi.): 60 / 20 / 13 / 8 / 4 Shirt (YM–A2XL):_____ Price: $_________Phone:____________________________ Email:_____________________________Address:______________________________________________________________ City/State/ZIP:_________________________________________________________
Participant Name:__________________________________________ M / F Age:_____ Length (Mi.): 60 / 20 / 13 / 8 / 4 Shirt (YM–A2XL): _____ Price: $ ________
Participant Name:__________________________________________ M / F Age:_____ Length (Mi.): 60 / 20 / 13 / 8 / 4 Shirt (YM–A2XL): _____ Price: $ ________
Participant Name:__________________________________________ M / F Age:_____ Length (Mi.): 60 / 20 / 13 / 8 / 4 Shirt (YM–A2XL): _____ Price: $ ________
Participant Name:__________________________________________ M / F Age:_____ Length (Mi.): 60 / 20 / 13 / 8 / 4 Shirt (YM–A2XL): _____ Price: $ ________
Participant Name:__________________________________________ M / F Age:_____ Length (Mi.): 60 / 20 / 13 / 8 / 4 Shirt (YM–A2XL): _____ Price: $ ________
Total: $ _______
I cannot attend. Please accept my donation: $ _______
— Visit www.bgclubpc.org/bike4bgc to raise funds by inviting your family and friends to support you and the Boys & Girls Club with monetary donations.— Awards will be given to individuals and teams on the basis of money raised & biking the most miles
Registration, maps, and donation forms
available at: bgclubpc.org/bike4bgc
— HELMETS ARE MANDATORY!— Youth who would like to participate but do not have a bike or helmet should call: (715) 341-4386.— Riders under 12 years of age must be accompanied by an adult.
Schedule of Events / Saturday, August 3rd
Start Times60 Mile.................................................................................................... 7:30am20 Mile.................................................................................................... 9:00am13 Mile.................................................................................................... 9:30am8 Mile...................................................................................................... 9:30am4 Mile Rich Johnson Family Ride........................................................... 10:00amPost Event Lunch & Games.................................................................... 10:30amAwards.................................................................................................... 11:30am
Location of Starting/Finish Line:AIG Travel:3300 Business Park Drive / Stevens Point, WI 54482
On Saturday, August 3rd, 2019, Bike for Boys & Girls Club starts and finishes at AIG Travel. This event brings family, friends, co–workers and neighbors together for a fun–filled ride through picturesque Portage County. Funds raised support the ongoing mission of the Boys & Girls Club of Portage County to provide programs that inspire and enable our youth to realize their full potential.
Cyclists of all ages ride as individuals or teams on one of five planned routes. Hundreds of riders will pedal their way across the finish line and into the post–ride party of King Cone ice cream, bounce houses, carnival games, and activities for the whole family.
Printing Sponsored by:
Packet Pickup:Front Desk of AIG TravelFriday, August 2nd from 9:00am-5:00pm
At the Registration TentSaturday, August 3rd starting at 7:00am
YES!Fees:
Boys & Girls Club Members: FREE for any rider, thanks to Mark Toyota of Plover
I would like to support Bike for Boys & Girls Club 2019
60, 20, 13, and 8 mile rides:Early Bird (by Friday, July 26th): $25Regular (after July 26th): $35Youth (under 18): $10
Go Green... Register OnlineWebsite: www.bgclubpc.org/bike4bgc
For more information: Contact Mikayla Kleifgen
Phone: (715) 341-4386Email: [email protected] Website: www.bgclubpc.org/bike4bgc
4 mile Family Ride:Adults: $10Youth: $10
Awards and Donations:
Rules and Regulations:
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