SATU

RD

AY

Perry A

rea Cham

ber of Com

merce

1102 Willis A

ve P

erry, IA 50220

Official Registration Form Participants Waiver of

Liability BRR-Bike Ride to Rippey

It is agreed that with respect to the event known as Perry’s BRR—Bike Ride to Rippey, each participant shall WAIVE all rights of recover for BODILY INJURY and hold harmless the City of Perry, Iowa, Boone County, Greene County and Dallas County, City of Rippey and Perry Area Chamber of Commerce and any of its representative for ALL LIABILITY arising from participation in any related events and or ac-tivities. The participant further acknowledges that Insur-ance DOES NOT apply to BODILY INJURY to any person while practicing for or participating in any contest or exhibi-tion of an athletic or sports nature sponsored by the City of Perry or Perry Area Chamber of Commerce, nor to immedi-ate medical or surgical relief to any person so injured.

Name:_________________________________________

Street Address:__________________________________

City::_____________________State:______Zip:________

Check here if new address ( )

Email address:___________________________________

Signature_______________________________________

Signature of guardian_____________________________ (required if participant is under 18) Ride Safety Notice: Due to staff reductions and potential hazards; public safety officials at the state, county and local levels have requested that BRR riders depart from Rippey at an appropriate time to ensure a safe return to Perry before sunset. They strongly suggest departing Rippey for the return ride by 2p.m. and no later than 3p.m.. WEARING HELMETS IS STRONGLY ENCOURAGED! Be sure to fill out BOTH sides of the registration form, sign the waiver and return entire form with your check to: Perry Area Chamber of Commerce 1102 Willis Ave Perry, IA 50220

Register online at : www.bikeiowa.com

39th Annual

2016

BRR February

6th

Pre –Register Pick-up & Day of Registration

Beginning at 7:30 a.m. inside the Hotel Pattee

1112 Willis Ave - Perry, IA

 

Ride starts at 10:00 a.m.

At the corner of 2nd Street & Willis Ave

The ride starts and ends in Downtown Perry Beginning at 7:30 a.m.

Registration, pre-registration pick-up, t-shirts & additional merchandise and Lion’s Club

Breakfast all at the Hotel Pattee 1112 Willis AVE

RIDE STARTS AT 10:00 a.m. AT THE INTERSECTION OF 2ND STREET &WILLIS AVE

FOR MORE INFORMATION ON BRR GO TO: WWW.BIKEIOWA.COM WWW.PERRYIA.ORG

PERRY AREA CHAMBER OF COMMERCE 515-465-4601 - perrychamber@perryia.org

Pre-Registered Riders Only!! Win Prizes! $500 in Perry Bucks!

Drawing for riders pre-registered by 2/5/2016

(If you are a winner ,your prize will be attached to your pre-registration packet!)

Official BRR long sleeve T-shirt 39th Annual BRR pin

(first 300 pre-registrants only) Chance to win $500 in Perry Bucks Hot Chocolate Break

brought to you by Hy-Vee Admission to McCreary Center for

pool, sauna & whirlpool Sag Wagon Drawings for Prizes! Special Discounts at local Merchants

Registration Includes:

Item Qty Amount

Pre-registration until 2/5/16 $25.00 Circle shirt size: S M L XL XXL

XXXL

Support the Ride $15.00 *NO MERCHANDISE

Day of Registration $35.00 Circle shirt size: S M L XL XXL

XXXL

Lion’s Club Breakfast $7.00

Additional McCreary Passes $3.00

Additional Long Sleeve T-Shirts

Small $17.00

Medium $17.00

Large $17.00

X-Large $17.00

XX-Large $19.00

XXX-Large $19.00

Donation Option: High Trestle Trail Connector

TOTAL ENCLOSED: $

THERE WIL BE A $6.00 SHIPPING FEE TO SHIP PACKETS– PACKETS ARE NOT GUARANTEED

TO ARRIVE PRIOR TO THE EVENT.

Official Registration Please cut off and return this portion to the

Perry Area Chamber of Commerce with your check.

T-SHIRTS ARE LONG SLEEVE ONLY THIS YEAR!

PLEASE USE ONE FORM FOR EACH

REGISTRATION. REGISTER ONLINE

@ www.bikeiowa.com

Ride held regardless of weather. All registrations final and non-refundable!!!

RO

UT

E M

AP

E57

HOTEL PATTEE

P54

PARK ST

FIR

ST S

T/ H

WY

14

4

E

HWY 141

WILLIS AVE

2nd

LUCINDA ST

PATTEE ST

WARFORD ST

HOT CHOCOLATE STOP

N

W

S RIDE ROUTE

Rippey (turn around point)

Mail forms to : Perry Chamber of Commerce 1102 Willis Ave - Perry, IA 50220

3rd

LA POSTE