To sign up before July 18, 2005, fill
out this form, print it and send with your payment to:
P.O. Box 757
Fairfax, CA 94978
After July 18, please register on day of event.
Make the check or
money order payable to: WOMBATS
confirmation by mail, send a self-addressed stamped envelope along
with this form.
For confirmation by email, check here:
Area Code and Phone Number
Under 18 (kid)
Over 40 (don't ask)
type of rider are you (check one)
Honest to goddess beginner
- or do you just race to the bathroom?
type of maintenance do you want to learn about (check a maximum of
Lube and tire change
Post ride maintenance
Pre-ride safety check
Events will be planned in accordance with response
I have enclosed payment
$85 for members
$100 for nonmembers before June 5
$110 for members on June 5 or after
Registration for event includes
lunch, teaching, and rides
Wombats tee shirt ($15)
4-color event tee shirt ($25)
In consideration of my entry, and of my own free will, I for myself
and my heirs, executors and heirdressers forever permanently waive
any claims or liability, including the usual worst-case scenarios
(broken nail, broken collar bone, broken neck) against Jacquie Phelan,
the Women's Mountain Bike & Tea Society, and its officers, which
may arise from my participation in the Teacup Tango on July 23, 2005.
I fully understand mountain biking has inherent risks, and agree
to AVERT the dreaded Starvation Scenario by having a huge, healthful
breakfast no more than two hours prior to the class.