Online Registration Forms
       
Postponed Until Further Notice
       
Power Pedal Event Information
Ride Date & Times (begins at the Chamber of Commerce, 1000 George St.)

September 27, 2008
8:30 am – 62 Mile
9:00 am – 4 Miles and 30 Miles
Check – in at 8:00 am HELMETS ARE REQUIRED FOR ALL RIDERS!
Ride Registration Fees (non-refundable)

Prior to September 22, 2008
7+ $15.00
6 & under $8.00

After September 22, 2008
7+ $20.00
6 & under $10.00
Same day registration will take place at Chamber of Commerce from 8:00 – 8:30 am.
Packets can be picked up at the YMCA (2975 Washoe) on Friday, September 26 from 12:00 (noon) to 6:00 p.m.
Make check or money order payable to:

Butte Family YMCA
2975 Washoe St.
Butte, MT 59701
(406) 782-1266
The Butte Family YMCA is a 501©3 nonprofit organization. Donations enable the YMCA to provide the best possible health and fitness opportunities to the residents of southwest Montana.
       
Pedal Power Registration
Thank you for being a part of the Butte Family YMCA’s 2008 Pedal Power!! The proceeds raised from this ride will go to support the YMCA’s Fitness
Program. Please complete all sections of this form and appropriate fees are sent to the address shown above.
       
First Name: *Required. Last Name: *Required.
Street Address: *Required. City: *Required.
State: *Required. Zip Code: *Required.
Age: *Required. Date of Birth: *Required.mm/dd/yyyy
Daytime Phone: *Required.    
Gender:
   
Race Type (Check One): T-Shirt Size (Check One):
 
 
Age Group (As of September 27, 2008):    
 
   
Ride Participant and/or Parent/Guardian Must Read and Sign!
In consideration of the acceptance of this entry form and for being permitted to voluntarily participate in this event, I hereby assume full and complete responsibility for any injury or accident which may occur during my participation in this event, and I hereby release and hold harmless the sponsors and organizers of the Butte Family YMCA and their agents and employees, and all other persons or entities associated with this event from any loss, liability, damage, or claims I may have arising out of my participation in this event, including personal injury or damage suffered by me or others, whether same be caused by falls, contact with other participants, conditions of the course, negligence of the Releasees, or otherwise. I also hereby consent to permit and accept responsibility for emergency treatment in the event of injury or illness. I give my full permission to the Releasees to use any photographs, videotapes, or recordings of me made during the course of this event for any purpose.
     
Yes, I Agree to the Terms and Conditions. You, must agee to the terms and Conditions..
 
       
       

 

 

 

 

 

 

 

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