Big Creek Trail Ride Registration Form

Big Creek Trail Ride Registration

Register for Big Creek Trail Ride by providing your demographic information, emergency contact, health information, and required signatures. More than one may register on this single form.
Full Name(s)

LAST NAME(S)FIRST NAME(S)
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2
CityStateZip Code
Date of Birth for Person 1

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Date of Birth for Person 2

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Age for Person 1
Age for Person 2
Emergency Contact
Emergency Contact Name

First NameLast Name
Emergency Contact Phone
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Relationship
Health Information
Do you have any medical conditions we need to know about?
Please explain
Do you have any allergies?
Please explain
Are you currently taking any medications we should know about?
Please list any we would need to notify paramedics of
Do you have any dietary restrictions we should know about?
Legal Disclaimer / Release

By signing below, I acknowledge that participation is voluntary and that I understand the inherent risks associated with trail riding. I release and hold harmless the organizers, volunteers, owners, and associated parties from liability for injury, loss, or damage, except where prohibited by law. I confirm that the information provided in this form is accurate to the best of my knowledge.
Signature 1
Date for Signature 1

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Signature 2
Date for Signature 2

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

Signature 1
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Signature 2
PARENT'S OR GUARDIAN'S ADDITIONAL INDEMNIFICATION

(Must be completed for participants under the age of 18)

In consideration of   First Name   Last Name   (minor's name) ("Minor") being permitted by BCTR to participate in it's activities and to use its equipment and facilities, I further agree to indemnify and hold harmless BCTR from any and all Claims which are brought by, or on behalf of Minor, and which are in any way connected with such use of participation by Minor.
First Name   Last Name
Signature   Date

Signature 1
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Signature 2
PARENT'S OR GUARDIAN'S ADDITIONAL INDEMNIFICATION

(Must be completed for participants under the age of 18)

In consideration of   First Name   Last Name   (minor's name) ("Minor") being permitted by BCTR to participate in it's activities and to use its equipment and facilities, I further agree to indemnify and hold harmless BCTR from any and all Claims which are brought by, or on behalf of Minor, and which are in any way connected with such use of participation by Minor.
First Name   Last Name
Signature   Date
Type a question
Should be Empty:

Big Creek Trail Ride Registration

Emergency Contact

Health Information

Legal Disclaimer / Release