Name

Email Address

Phone

Address (Street)

City

State

Zip

Gender (optional)

Age (optional)

Do You Have a Roommate? Do You Have a Roommate?YesNo

Roommate Name

Please Assign Me a Roommate Please Assign Me a RoommateYesNo

Emergency Contact (Name & Number)

T-Shirt Size Women (optional, additional cost) T-Shirt Size Women (optional, additional cost)Women's XSWomen's SWomen's MWomen's LWomen's XLWomen's XXLWomen's 3XL

T-Shirt Size Men (optional, additional cost) T-Shirt Size Men (optional, additional cost)Men's XSMen's SMen's MMen's LMen's XLMen's XXLMen's 3XL

Pedal & Paddle Option Pedal & Paddle OptionYesNo

Kayak Type Kayak TypeSingle KayakDouble Kayak

Life Jacket Life JacketXS/S (30-36)M (36-40)M/L (36-44)XL/2XL (44-56)

Type of bicycle you will be riding (i.e. road, touring, mountain, recumbent, etc.)

Signature / Waiver of Liability: *BY CLICKING & TYPING YOUR NAME IN THE SIGNATURE BOX, you are accepting the entire waiver of liability that follows*: I understand that this Release and Waiver of Liability applies to my participation in Around Wisconsin Bicycle Tours’ Northern Woods and Waters Bicycle Tour taking place on August 8-14, 2020. This is a legal document and its intent is to prevent you and anyone representing your interests from being able to sue Mindful Journey Cycling Adventures, LLC, dba Around Wisconsin Bicycle Tours, its owners, staff, volunteers, and any other parties connected with this event in any way for any injury, death, property damage or other loss to you that occurs as a result of your participation in the Northern Woods and Waters Bicycle Tour taking place on August 8-14, 2020. If you have any questions about the terms of this document or their legal significance, consult with an attorney before signing it. 1.In signing this release, I acknowledge that I understand the nature of Northern Woods and Waters Bicycle Tour specifically and bicycle touring generally (“Activity”) and represent that I am qualified, in good health, and in proper physical condition to participate in the Activity. I further acknowledge that the Activity will be conducted over public roads and facilities open to the public during the Activity and upon which the hazards of traveling are to be expected. I further agree and warrant that if, at any time, I believe conditions to be unsafe, I will immediately discontinue further participation in the Activity. Further, I acknowledge and understand that the scope of the activity includes, but is not limited to bicycling, equipment transport, personal transport, food services, sleeping and personal care facilities and arrangements and otherwise. 2. I fully understand that (a) the activity involves risks and dangers of serious bodily injury, including but not limited to permanent disability, paralysis and death(“Risks”); (b) these risks and dangers may be caused by my own actions, or inactions, the actions or inactions of others participating in the Activity, the condition in which the Activity takes place, or the negligence of the “Releases” named below; (c) there may be other risks and social and economic losses either not known to me or not readily foreseeable at this time. 3. The foregoing understood, I hereby release and waive any and all claims against Mindful Journal Cycling Adventures, LLC, dba Around Wisconsin Bicycle Tours, Mary Jo Filbrandt, major sponsors, cooperating organizations, and any other parties connected with this event in any way, (“Releases”) singularly or collectively, and further hold harmless and indemnify such releases from and against any liability, claims of negligence, misadventure, harm, loss, inconvenience or damage hereby suffered or sustained as a result of participation in the Northern Woods and Waters Bicycle Tour or any other activity associated therewith. The foregoing notwithstanding, this is NOT a release and waiver of intentional or reckless acts. Such release, waiver, hold harmless and indemnity shall apply to my own claims and /or claims of third parties including but not limited to spouse and family members, relating to my participation in this event. This waiver is made in the state of Wisconsin and the laws of Wisconsin govern its terms regardless of the participant’s place of residency. 4. I hereby consent to and permit emergency treatment, in the event of injury, illness or death. Around Wisconsin Bicycle Tours (Mindful Journey Cycling Adventures, LLC) reserves the right to decline accepting or retaining any tour participant whose health or actions impede the operation of the tour or welfare of other tour participants. 5.I give full permission for use of my name and photograph, motion pictures, videotapes, recording or other record of this event for any legitimate purpose including print and internet advertising for Around Wisconsin Bicycle Tours 6. I have read this agreement, fully understand its terms, understand that I have given up substantial rights by signing it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of liability, within its terms, to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid the balance notwithstanding, shall continue in full force and effect. The undersigned acknowledges having read and agreed to the terms of the foregoing Release and Waiver of Liability agreement. In this regard, the undersigned acknowledges and agrees that if the terms of the agreement are not acceptable the undersigned has the choice and option to forego participation in this voluntary event.

Signature/Name of Participant

Date

Name/Signature of Guardian if registrant is under 18 years of age

Date

How did you find out about Around Wisconsin Bicycle Tours? (If the web, please tell us which website).

Number