If you would like to save 50% off on your registration fee, why not take up pledges towards F.O.C.I.S.? Total pledges must be a minimum of $150.00 and are tax deductable.

Choose *Pledge Package option on registration form to save yourself 50%.

Bike-A-Thon Online Registration -- Safe and Secure Site
Complete the form below and press "submit".
Thank you for supporting our youth.

Contact Information

Full Name: Email:
Address:
City: State: Zip Code:
Day Phone: Evening Phone:

Other Questions or Comments:

Event T-Shirt Sizes... (2x & 3x T-shirts are an additional $3 surcharge)

S M L XL 2X 3X
Children's Event T-Shirt Sizes
Ch-S Ch-M Ch-L Ch-XL

Volunteer Workers Please Select A Service You Would Like To Help With

Bike Tech Bike Tech With Motorcycle Van Driver Route Director

Rest Stop Worker First Aid BBQ Staff Fun Day Event Staff

Registration - Choose One ...(2x or 3x T-shirts choose $3 surcharge option)

$50.00 -- Bike-A-Thon Registration Without *Pledge Package

$53.00 -- Bike-A-Thon Registration Without *Pledge Package (Includes 2X/3X $3.00 T-shirt surcharge)

$25.00 -- Bike-A-Thon Registration With *Pledge Package

$28.00 -- Bike-A-Thon Registration With *Pledge Package (Includes 2X/3X $3.00 T-shirt surcharge)

$15.00 -- Jr. Bike-A-Thon Ride Registration (Ages 5 to 12)

$25.00 -- Walk-A-Thon Registration

$28.00 -- Walk-A-Thon Registration (Includes 2X/3X $3.00 T-shirt surcharge)

$25.00 -- Worker Registration

$28.00 -- Worker Registration (Includes 2X/3X $3.00 T-shirt surcharge)

*Pledge Package: If you would like to save 50% off on your registration fee, why not take up pledges towards F.O.C.I.S.? Total pledges must be a minimum of $150.00 and are tax deductable.
Participation Waiver

With full knowledge and appreciation that bicycle riding and walking on public streets and walkways are hazardous activities, I assume all risks attendant thereto and thus release, waiver and forever discharge F.O.C.I.S., the sponsors, the volunteers, any involved public entity and their respective owners, officers, employees, agents, representatives, successors, and assigns from any and all liability or responsibility for injuries and/or property damage which I may sustain during the event or during my travel to or from the event. This waiver release covers myself and all parties herein, and all heirs, executors or administrators thereto, and is given in full awareness of its content and in consideration of acceptance of my application/entry to the event. I also attest that I am physically fit and acknowledge that the sponsors require the wearing of a hard shell helmet when riding a bicycle. Further I agree to abide by the rules and regulations of the event, the vehicle laws of the State of California and any local municipal laws applicable. I understand that at this event I may be photographed. I agree to allow my photograph to be used for any legitimate purpose.

I HAVE READ, UNDERSTAND AND ACCEPT ALL OF THE ABOVE, I CERTIFY THAT I AM AT LEAST 18 YEARS OF AGE.

I AM NOT 18 YEARS OF AGE OR OLDER, MY PARENT OR LEGAL GUARDIAN HAS READ, UNDERSTANDS AND ACCEPTS ALL OF THE ABOVE AND WILL BE SIGNING ON MY BEHALF.

NO HELMET -- NO RIDE -- NO EXCEPTIONS
Credit Card Details
Credit Card Number:
Expiration Date: Month: Year: - (mm-yy)
Your registration choice determines the amount your credit card will be charged.
 
A Rider's Packet Will Be Sent To You Upon Receiving This Form.