Register

2010 Cycle for Life - Celebrate Life: 4,000 KMs for the Cure.

Departure Date: October 11th, 2010

Please download and read the following Liability Waiver Document prior to online registration.

Download and Read ==>> Waiver and Release of Liability 2010

Rider Registration

1. First Name(required)
2. Last Name(required)
3. Date of Birth (MM/DD/YYYY)(required)
4. Age(required)
5. Gender
6. Male Female
7. Your Email(email required)
8. Phone Number(required)
9. Alternate Number

Your Address

1. Street Address(required)
2. City(required)
3. State/Province -Please select one- Outside US & Canada AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WI -- Canada -- BC AB SK MB ON QC NB NS PE NL YT NT NU (required)
4. ZIP/Postal Code(required)
5. Country -Please select one- Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas, The Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Côte d'Ivoire Croatia Cuba Cyprus, Republic of Cyprus, Turkish Republic of Northern Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France France, Metropolitan French Guiana French Polynesia French Southern Territories Gabon Gambia, The Gaza Strip Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jericho Area Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic of Korea, Republic of Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar (Burma) Namibia Nauru Nepal Netherlands, The Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Island Poland Portugal Puerto Rico Qatar Réunion Romania Russia Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and the Grenadines San Marino São Tomé and Príncipe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia & the South Sandwich Islands Spain Sri Lanka Sudan, The Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States selected United States Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City State (Holy See) Venezuela Vietnam Virgin Islands (British) Virgin Islands (U.S.) Wallis And Futuna West Bank Western Sahara Western Samoa Yemen Yugoslavia Zaire Zambia Zimbabwe OTHER (required)
6. Citizenship(required)
7. Personal Skills
8. Are you interest in volunteering
9. Yes No
10. What kind of time do you have to offer?
11. Please list any volunteering experience
12. Do you have bike Mechanic Skills?
13. Yes No
14. Are you Certified in CPR?
15. Yes No
16. Are you Certified in First Aid?
17. Yes No
18. Names of desired teammates? (Optional)
19. How did you hear about GIVETOLIVE?

Registration Agreement

1. I have read the above Liability Waiver and agree to all terms and conditions
2. I recognize that I am not officially registered for the 2010 ride until a deposit has been received by GIVETOLIVE. For this deposit I shall do one of the following:
3. Deposit Type
4. Mail in my deposit for $200 Sponsor myself online for $200
5. NOTE: Mail Deposit option - Once you have raised $5,000, you may request to have the $200 returned to you.
6. NOTE: Sponsor myself online option - I recognize I am making a donation for which I will receive a charitable receipt. Note: if you choose this option, you cannot have the $200 returned to you at any time.

Confirmation E-mail

1. CC me please

Verification

1. Enter Validation

 

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If you live out of town, please check our FAQ section and if you can’t find the answer, email Ashley at award@givetolive.ca. Please check FAQ first as we are all volunteers… so lots of questions means lots of work. Thanks.

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