REGISTRATION Pedal for a Cure Spinning Class We are excited to have you ride with us! Please fill out the registration form below. Fundraising Spinning Class* Price: $50.00 Choose Event*Nitro Flex October 22 8:00 SpinNitro Flex October 22 9:00 SpinNitro Flex October 22 10:00 SpinWould you like to ride for more than one hour?*NoYesAdditional Hours of Riding* Price: $50.00 Additional Hours of Riding:If you would like to ride for more than one hour it is $50 for each additional hour (i.e. riding from 8:00-9:00pm and 9:00-10:00pm = 1 additional hour of riding)Please enter a value greater than or equal to 1.Choose Your Time(s)* No available time slots remaining Choose Your Time(s)* No available time slots remaining Choose Your Time(s)* No available time slots remaining. Name* First Last Email*Please make sure this email is correct. This is where your confirmation will be sent! Commemorative Sign Price: $20.00 Personalize your bike with a special tribute sign*NoYesSelect a tribute*In Memory ofIn Honor ofDedicated toName of person to be honored*T-Shirt Size* S M L XL Additional DonationWould you like to contribute an additional donation to help support our fundraising efforts? Total $0.00 Waiver* I Agree In signing this release, I understand the intent thereof, and I, for myself, my heirs, executors, and administrators, hereby agree and will absolve and hold harmless Pedal For a Cure from and against any blame and liability from my participation in all Pedal For a Cure events and any activities associated herewith. I hereby attest that I am physically fit and prepared for this event. All participants must be 15 years of age or older as of the day of the event. I also hereby consent to and permit emergency treatment in the event of injury or illness. I also give full permission for use of my name and photograph in any materials produced by Pedal For a Cure.