Bike for the Cure - 2005

Registration Form

To register for the Bike for the Cure, please fill out the following form in full and submit it to Adventure Racing Canada by clicking Go For It below, faxing it to 416-486-4481 or mailing it to: Adventure Racing Canada, 15 Lesmill Rd., # 3, Toronto, Ontario M3B 2T3

Receipt of your e-mail registration form by Adventure Racing Canada will be confirmed by an automatic e-mail confirmation when you click on Go For It. Receipt of your form by fax or mail will be confirmed by a return phone call or e-mail, usually within 2 business days.

Registration for the Bike for the Cure will only be confirmed upon complete payment of your registration fee.

Items marked with * are required.

Registration Fee:

$25 - on or before May 30, 2004 (and $35, after May 30, 2005) - participants over age 12yrs

$10 - on or before May 30, 2004 (and $15, after May 30, 2005) - participants 12yrs and under



*Your pledges are separate from the cost of registration and go directly to the Canadian Breast Cancer Foundation (CBCF) - Ontario Chapter . Please bring your pledge forms and all donations to the event on June 4, 2005.
 
  Participant Name Participant Name Participant Name
Name *
Sex

Male Female *

Male Female

 

Male Female

 
Age Age 12 or older Under age 12 *      Age 12 or older Under age 12     Age 12 or older Under age 12
Mailing address *
Tel: Home *
Tel: Work
Fax
E-mail * 
Occupation
Tell us about yourselve(s), why you are participating and who you are biking for?:
 

Payment Method* Cheque         Visa       Master Card        American Express
(* this is not a secure site, and if prefered please phone 416-444-3899 or fax 416-486-4481 your credit information)
Your Credit Card #    
Expiry Date (MM/YY)
    
Cardholder Name    
  Number of Adult Participants
$20 each ($25, after May 30, 2005)
 Sub total
  Number of Child Participants $10 each ( $15, after May 30, 2005) Sub total
   
Total Payment

 

Payment and Registration Notes:

  • Payments made by cheque should be made payable to: Bike for the Cure
  • Post dated cheques will not be accepted and any NSF cheques will be charged a $25.00 handling fee
  • If you prefer not to send your credit card information by e-mail, please phone 416-444-3899 or fax 416-486-4481
  • Sorry, No refunds for no shows.
  • If a receipt is required for registration payment, please send a self addressed stamped envelope with payment.
  • Please note that registration fees are not eligible for tax receipts.
  • After you register, all correspondence will be with the first person listed on the registration form if not otherwise advised.
  • Check-in and race kit pick-up closes 1/2 hour before the start of the event.
  • All participants will be required to sign a waiver on event day. If participants are under age 18, a Parent or Guardian must be available to sign waivers on race day.
  • All entry fees include 7% GST
  • All information printed in this registration form is considered correct at the time of printing but is subject to change. Please contact 416-444-3899 for further details.