GAPCO Bike Tour Two 2016 Registration Clearly July 4 July 10, 2016

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1 GAPCO Bike Tour Two 2016 Registration Clearly July 4 July 10, 2016 Please Type in Information or Print Name: Male: Female: Address: Age Birth Date / / Shirt Size: City, State & Zip: Address: Cell Phone: Emergency Contact Name: Relation: Home Phone: Cell Phone: Address:: City, State, Zip: Vegetarian: No Yes Note: Vegetarian is the only additional menu option available How did you hear about this tour? Internet Search Word of mouth/friend Magazine Ad Medical Conditions Do you have any medical conditions you wish to share and make Bubba aware of? This information will be held in the strictest of confidence and not shared. If so, please explain. Fees: Single not sharing a room: $1,990 Double, sharing a room: $1,675 *If registering for a double, please note on registration form who you will be sharing with. Note: If registering as a double you may be sharing the same bed at times. I will be sharing with who will also be registering Deposit of 50% is required at time of registration. Reminder is due June 1, 2016 Make check for the full amount payable to: Bubba Barron PO Box Please remember to use Sunscreen. Melanoma KILLS Tampa, FL Cancellation Policy/Refund This event realizes unplanned issues come up which makes changing plans a must. If you cancel before June 1, 2016 there will be a $600 Cancellation Fee. Due to contractual obligations, there will be no refund after June 1, This cancellation policy must and will be enforced. Please do not ask for an exception. Thank you for understanding. Trip insurance is available from various sources. Again, the

2 stated cancellation policy will be strictly enforced with no exceptions. Attached waiver form and cancellation acknowledgement form must be signed unaltered and sent with registration in order for the registration to be processed GAPCO Bike Tour Waiver and Release This waiver is a contract with legal consequences. Please read this carefully. I, the undersigned, know that GAPCO Bike Tour is a potentially hazardous event, and attend it out of my own free will and choice. In choosing to attend GAPCO Bike Tour and any related events or activities, I fully accept and assume all risks, whether before, during or after GAPCO Bike Tour and/or related events or activities. These include, without limitation, risk of physical injury mental injury, mental stress, emotional stress, trauma, death, contact with other participants, equipment failure, inadequate safety equipment, effects of weather including extreme temperature or conditions, traffic, contact with motor vehicles of all types and descriptions, collision with other riders or fixed or moving objects, the conditions of the roads, theft, camping and participating in events or activities along the route. All risks are known, understood, and appreciated by me. I waive any and all specific notice of the existence of risks. I agree that leaders and maps are provided for my convenience only and do not guaranty a safe route or trip. I shall assume and pay my medical and emergency expenses in the event of injury, illness or other incapacity regardless of whether I authorized such expense. I realize GAPCO Bike Tour requires physical conditioning and I represent that I am in sound medical condition capable of participating in the ride without risk to myself or others. I have no medical impediment that would endanger myself or others. I understand that situations may arise during GAPCO Bike Tour that may be beyond the control of sponsors, promoters and organizers. I will be solely responsible for the condition and adequacy of my bicycle, safety gear and riding equipment. I will ride safely within the limits of my own abilities, my equipment and the riding conditions and in a manner so as not to endanger myself or others. Knowing these facts and in consideration of my entry, acceptance, admission to and participation in GAPCO Bike Tour and its related events and activities, I, for myself and anyone acting on my behalf, waive, release, discharge, indemnify, covenant not to sue and agree to hold GAPCO Bike Tour, Bubba s Pampered Pedalers, the staff of Bubba s Pampered Pedalers, any and all sponsors, communities, organizations, GAPCO Bike Tour, and Bubba s Pampered Pedalers employees-representatives-volunteers, agentsinsurers-insurance brokers and successors of all above, harmless from any and all claims, demands and actions of any and every kind that I have, may have or may hereafter accrue against the released parties, directly or indirectly, arising out of or relating in any respect to my attendance or participation in Bubba s Bike GAPCO and its related events and activities, including, without limitation, litigation expenses, attorney fees, loss liability, damages or cost. My waiver and release of all claims, demands, actions and liability shall include, without limitation, any injury, damage or loss to my person or property which may be caused by any act, or failure to act, by the above identified persons and entities or sustained by me before, during or after GAPCO Bike Tour and its related events and activities. I agree to abide by all GAPCO Bike Tour rules and regulation. I waive my rights of privacy or publicity and grant permission to all of the forgoing to use any photographs, motion pictures, videotapes, recordings or other record of this event for any legitimate purpose. I further agree to indemnify and hold the parties released above harmless from any and all losses, damages, claims and expenses, including attorney fees, arising from or relating in any respect to my participation in GAPCO Bike Tour or its related events and activities. If I am a minor, my parent or guardian is also signing on my behalf and we both agree to be bound by the same terms of this agreement, waiver and release. If I am the parent or legal guardian of a minor child participant, I certify that the minor is in good health, qualified and in proper physical condition to participate in Bubba s GAPCO Bicycle Tour and I hereby release, discharge, covenant not to sue, and agree to indemnify and save and hold harmless all of the above released parties from all liability, claims, demands, losses or damages on the minor s account incurred in connection with GAPCO Bike Tour or its related events and activities. I will indemnify, save and hold harmless each of the released parties from any litigation, expenses, attorney fees, loss liability, damage or cost that may occur as the result of any such claims in connection with the minor s participation in GAPCO Bike Tour and its related events and activities Signature (signature of parent or guardian if under 17 years of age) Print Full Name

3 Pittsburgh Riverfront Pedal Plan to stay in Pittsburgh a day longer for a guided tour by Pittsburgh natives and veteran GAPCO riders Snowflake and Lillian. Discover why Pittsburghers love their beautiful city and why Pittsburgh consistently lands on the top 10 lists of most livable cities. Leaving mid-morning, Sunday July 3, 2016, from the Waterfront you pedal into the city of Pittsburgh for your first photo op at the terminus of the GAP located at Forks of the Ohio marker near the fountain in Point State Park. After a short stop across the river you will go, to the North Shore on our way to the famous Bicycle Heaven bicycle museum, a must see. Bicycle Heaven, home to 3,500 bicycles, is not only a museum but the largest bicycle shop in the United States. The shop contains over 3,000 antique and collectible bikes including Pee- Wee Herman s bike from the Big Adventure! Literally, the floor to the ceiling is covered with amazing machines that appeal to all ages. Whether you're an avid biker, a collector or simply someone who enjoys a bike ride around your neighborhood; there s something in the 5,000 square feet that will catch your eye and put a smile on your face. You will have plenty of time to explore this one-of- kind attraction. Next stop, the Monongahela Incline. USA Today calls it one of the top 10 sites in the world for viewing a cityscape. We are sure you will agree. You will have plenty of time to enjoy the views while taking those memory pictures. Leaving the incline, it will be a short ride to lunch, provided by the tour, at one of Pittsburgh s favorite restaurants allowing you to "belly-up" while enjoying some of the local fare. Hope to see Yinz on the Pittsburgh Riverfront Pedal. Make your plans now to join the others; it will be just too much fun to miss. This 25 mile guided tour will be on paved trails and will offer a great opportunity to get to know your fellow GAPCO riders while enjoying a great day of sight-seeing. Tour Guide Entrance to Bicycle Heaven Entrance to Monongahela Incline Fabulous Lunch including non- alcoholic beverage Extra Memories Laughs What s Included Chance to get to know your fellow GAPCO riders sooner Fee for this great day tour is $75 per rider. Additional registration form must be completed and mailed, along with extra fee, with your GAPCO registration. Advance registration is required. Yes, I would love to take advantage of this outstanding day tour. I understand the fee for Pittsburgh Riverfront Pedal is $75 per rider and said fee in not included as part of the registration fee for GAPCO. The $75 fee needs to be added to and included with the registration fee. I also understand advance registration is required and understand Pittsburgh Riverfront Pedal will go rain or shine. No refunds will be offered. Name: Signature:

4 Must be mailed with registration forms in order for the registration to be processed. GAPCO Bike Tour Cancellation Police Please read carefully and fully understand before sending in your payment. This cancellation policy will be strictly adhered to. Please, DO NOT ask for exceptions to this cancellation policy, none can/will be granted. This event realizes unplanned issues come up which makes changing plans a must. If you cancel before June 1, 2016 there will be a $600 Cancellation Fee. Due to contractual obligations, there will be no refund after June 1, This cancellation policy must and will be enforced. Please do not ask for an exception. Thank you for understanding. Trip insurance is available from various sources. Again, the stated cancellation policy will be strictly enforced with no exceptions. Trip Insurance Trip insurance is highly suggested and available from many sources. Please review cancellation policy once again while deciding if trip insurance is an option you should consider. Again, this tour cannot stress enough; the stated cancellation policy will and must be strictly adhered to. NO EXCEPTIONS can/will be allowed for ANY reason. If you must cancel, the tour will be more than happy to assist you in filing a claim with your trip insurance company. I am fully aware of the stated cancellation policy and understand stated cancellation policy will and must be strictly enforced. I also understand trip insurance is available from various sources and if for any reason I must cancel, I understand the tour will assist in filling a claim with said insurance company. Printed Name: Signature: Date: Must be mailed with registration forms in order for the registration to be processed.

5 Double Occupancy GAPCO Bike Tour I understand if registering for the discounted double occupancy rate registrations for both riders will be mailed together. I also understand, if registering as a double, I may be sharing the same bed with the other rider registering to share with me. Printed Name: Signature: Safety Promise While riding on this tour, I promise at all times to: Wear my bicycle helmet while riding my bicycle Wear bright clothing making myself more visible Equip my bicycle with a rear blinking light and have light blinking while riding Use standard hand signals announcing turns Not wear any type of headphones while riding my bicycle Not to talk on cell phone or text while riding my bicycle Obey all traffic signs and signals Ride defensively always being aware of other riders, vehicles, and pedestrians around me, never assuming what they are doing or what they are about to do. Call out car up/car back to riders around me Point out road hazards and yell Gravel Hole Glass etc to riders around me Call out my intentions to riders; Slowing Stopping Turning Ride in single file when a motor vehicle is behind me Never ride more than two abreast and never be a road hog thus allowing motor vehicles and other bicyclists plenty of room to safely pass Always ride as far to the right as safely possible Use common sense and be courteous towards motorists and other bicyclists Never to ride before daylight or after dusk. If stopping for any reason, I will move completely off the roadway Call out On your left while passing a slower rider and never pass on the right. I understand and fully accept I can and may be removed from this tour, without refund, if I do not obey these safety rules. To be a smart, safe, and savvy bicyclist Printed Name Signature Date

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