Name:________________________________________________________________
Address:_____________________________________________________________
City:____________________________________ State:______ Zip:__________
Telephone: Day: (___)_________________ Evening: (___)________________
E-mail address:______________________________________________________
Birth Date:___________________ Age:________ Gender:__________________
Do you wish to have your bike transported to Washington: __ Yes __ N0
Please indicate the dates you plan to ride, where you plan to stay, and your preference for shuttling between Cumberland and Meyersdale:
__June 07 - Saturday in Washington |
__St. Gregory __Other |
No fee |
__June 08 - Sunday Washington to Leesburg |
__Best Western __Camping-Turtle Run __Camping-Marble Quarry __Other |
__ $18.75 |
__ June 09 - Monday Leesburg to Shepherdstown |
__Days Inn __Camping-Antietam Creek __Camping-Killiansburg Cave __Other |
__ $18.75 |
__ June 10 - Tuesday Shepherdstown to Hancock |
__Super 8 __Camping-Little Pool __Camping-White Rock __Other |
__ $18.75 |
__ June 11- Wednesday Hancock to Paw Paw |
__Red Rooster Hostel __Heritage Trail B+B __Town Hill B+B __Camping Red Rooster __Camping-Paw Paw Tunnel __Other |
__ $18.75 |
__ June 12- Thursday Paw Paw to Cumberland |
__Inn At Walnut Bottom __Camping-Evitts Creek __Other |
__ $18.75 |
__ June 13 - Friday Cumberland to Confluence |
__Shuttle to PA state line __Shuttle Meyersdale __WMSRR to Frostburg/shuttle to PA state line (Train fare is not included.) __WMSRR to Frostburg/shuttle to Meyersdale (Train fare is not included.) __Hannahouse B+B __Parker House B+B __Camping-Hannahouse __Camping-Youghiogheny Dam __Other |
__ $18.75 |
__ June 14 - Saturday Confluence to Cedar Creek Park |
__Holiday Inn __Scarsdale B+B __Bright Morning B+B __Other |
__ $18.75 |
__ June 15 - Sunday Cedar Creek Park to McKeesport |
End of ride |
__ $18.75 |
Total fee |
$____________ |
1 day = $18.75 2 days = $37.50 3 days = $56.25 4 days = $75.00
5 days = $93.75 6 days = $112.50 7 days = $131.25 8 days = $150.00
Depending on demand we like to arrange for 3 dinners together. Please sign up if you are interested. Price of the dinner is not included. You will pay when you get your dinner
Saturday June 7 in Washington at 6:30 pm at the ---------- ---Prices range from ------- to ------
Wednesday in Paw Paw a Picnic Grill at 6:30 pm at the Red Rooster Hostel, price about $10
Dinner at the Scarsdale Bed and Breakfast at 6:30 pm, price about $10
General Release and Indemnification:
I, ___________________________________________________________________, agree to participate in the 2003 Yokatomac Trek, a bicycle ride from Washington, DC to McKeesport, PA, beginning June 07, 2003 and ending June 15, 2003. I specifically RELEASE and DISCHARGE, on behalf of myself, my heirs, my personal representatives and assigns, the Allegheny Trail Alliance and the Yokatomac Trek, their affiliates and their agents, representatives, officers, directors, employees, successors, and assigns, members or any affiliate of any person or entity of them, from any and all liability, whether known or unknown, even though that liability may arise in whole or in part out of the negligence, omission, or carelessness on the part of persons or entities mentioned above. I further RELEASE and DISCHARGE the above said entities and persons from any and all actions, causes of action, damages, demands, injuries, and liabilities of any nature, including reasonable attorneys’ fees and interest, arising out of or in any manner connected with their involvement with my participation in the above referenced activity. I am a voluntary participant in this event, and in good physical condition. I agree to accept all responsibility for the risks, conditions and hazards which may occur whether they now be known or unknown. Being fully aware of the risks, conditions, and hazards of bicycle riding, I HEREBY AGREE TO WAIVE, RELEASE AND DISCHARGE any and all claims for damages, personal injury, property damage, or death, which I may have or which may hereafter occur to me as a result of my participation in such activity against any person or entity mentioned above whether such injury or damage was foreseeable.
I further agree to forever hold HARMLESS AND INDEMNIFY all persons and entities identified above, generally or specifically, for any and all claims brought against them from any and all liability for personal injury, property damage, and/or death resulting in any way from my participation in the 2003 Yokatomac Trek.
THE UNDERSIGNED HAS READ AND VOLUNTARILY SIGNS THIS RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT, AND FURTHER AFREES THAT NO ORAL REPRESENTATIONS, STATEMENTS OR INDUCEMENTS APART FROM THE FOREGOING WRITTEN AGREEMENT HAVE BEEN MADE.
Signature:__________________________________________________ Date:______________________