BRO Ride Pre-Registration Form 2022
Welcome to the BRO Ride 2022
Name of Driver / Rider
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Signature
*
Clear
Double Rider ONLY (if you have a passenger)
First Name
Last Name
Signature
Clear
Name of minor (if applicable)
First Name
Last Name
THIS IS A WAIVER AND RELEASE OF LIABILITY, INDEMNIFICATION, AND CONSENT TO MEDICAL ATTENTION. I HAVE READ THIS WAIVER,RELEASE OF LIABILITY, INDEMNIFICATION, AND CONSENT TO MEDICAL ATTENTION. I UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT. I AM SIGNING THIS WAIVER, RELEASE OF LIABILITY, INDEMNIFICATION, AND CONSENT TO MEDICAL ATTENTION VOLUNTARILY ON BEHALF OF MYSELF AND ANY MINOR(S) ACCOMPANYING ME.
*
YES
My Products
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Single Rider
$
20.00
*Ride registration includes Mission BBQ lunch!
Rider with Passenger
$
25.00
*Ride registration includes Mission BBQ lunch for rider and passenger!
Enter coupon
Apply
Total
$
0.00
Coupon Codes for OCB Support Members can be requested by emailing MEMBERSHIP@COMBATBIKESAVER.ORG
or visit our website to sign up to be a member at https://www.combatbikesaver.org/support-membership.html
Payment Methods
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
submit
the form.
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