REGISTRATION

FORM

19th Cityhood Anniversary Celebration

Please Fill All Information

Name:
_____________________________________
Address:
___________________________________
____________________________________________
Birth Date: ________________Age:____
Sex:_____
Bike
Club/Assoc:___________________________
____________________________________________
Contact No.:
_______________________________
E-mail
Add.:________________________________
Race Categories:
___ Team

___ Women

___ Open Pro (Professional Riders)

___ Fun Ride A (Beginners 15 y/o

& below)
___ Executive A (PRC License Holders)

___ Fun Ride B (Beginners 16 y/o to 30

y/o)
___ Executive B (Businessmen)
___ Executive C (41y/o to 54 y/o)

___ Fun Ride C (31 y/o to 40 y/o)

___ Mega Men (75 kg & 37 inches

WL)
___ Executive D (55 y/o & above)

WAIVER and QUITCLAIM

I hereby certify that I am physically fit to participate in the said race. Being aware of the risks
involved and in consideration of the acceptance of my participation in BIKE THE DUST 26, I, my
heirs, my assignee and successors do hereby forever release, waive and quitclaim any and all causes
of action whether civil or criminal against the organizers, their offices, the sponsors, the tenants and/or
owners of the private properties thru which the race event will traverse, and hereby waive now and
forever all our claims, demands and causes of action against the aforementioned entities and
individuals resulting and/or as a result of accidents, loss, death and injuries that may occur during the
event.

APPLICANTS SIGNATURE:

DATE:

PARENTS OR GUARDIANS CONSENT (FOR APPLICANTS BELOW 18 YEARS

OLD)
NAME OF PARENT/GUARDIAN AND SIGNATURE:
REGISTRATION FEE: MTB TEAM PhP 3,000.00/ Registration Fee of PhP 300.00 to all
categories.