Randonneurs USA

Colorado Brevet Series 2001
Rocky Mountain Cycling Club
Randonneurs USA

Rocky Mountain Cycling Club
[ 2001 Schedule  ----  Results  ----  Application Form  ----  Rules & Tips  ]

Colorado Brevet Series 2001 -- Application Form
Rider Information:

Name: __________________________

Address: ________________________

_______________________________

City: ________________

State: ___ Zip: _______

Phone: (Day) __________________

Phone: (Eve) __________________

E-mail: ________________________

RUSA member #: _________
   Applied for

Register for one or more Brevets:
   200km May 6th No charge.*
   300km May 19th No charge.*
   400km June 16th No charge.*  Register by June 4th.
   600km June 30th No charge.*  Register by June 15th.
   1000km June 30th No charge.* †  Register by June 15th.
   300km July 28th No charge.*  
   1200km Sept. 7th Charge TBD.* ‡  Register by Aug. 10th.
   200km Sept. 23rd No charge.*
.

RMCC Membership* $25 … $____

TOTAL …………………………. $____

Make check payable to: Rocky Mountain Cycling Club. Mail with signed waiver (below) to: Rocky Mountain Cycling Club, c/o Catharine-Guy Lookingbill, 2756 West 107th Ct. #A, Denver CO 80234

* RMCC Membership is required for all brevets, for insurance. If you aren’t currently an RMCC member, indicate which type of membership you desire (same price):
   Individual    Family

† Possible additional charge for bagdrop -- event director will contact you. 
‡ Fee not finalized -- event director will contact you.

WAIVER: In signing this release, I acknowledge that I understand its intent, and I for myself, my heirs, executors, administrators, and representatives, do hereby agree and will absolve and hold harmless the Rocky Mountain Cycling Club and any other parties connected with this event/these events in any way, from and against any blame and liability for any harm, loss, inconvenience or any other damage of any kind whatsoever, which may result from or be connected in any way from my participation in this event/these events.

In addition to the absolute and unqualified release from all liability, I hereby represent that I am physically capable of participated in this event/these events; that my bicycle and any other equipment I may use is in good working condition; that I will observe all applicable traffic and event rules; and that I will wear a helmet and generally conduct myself in a safe and prudent manner while participating in the event(s).

I further agree to abide by the rules for riders of brevets.

I certify that I am a member in good standing of the Rocky Mountain Cycling Club, and that I have read this waiver and release and understand its significance.

_____________________________________________________________________________
Participant’s Signature, Date

Rules in brief: Rider must be at least 18 years old and be a member of the Rocky Mountain Cycling Club. Helmets are required. Legal lights are required on your bike before dawn and after dusk – rider must wear a reflective vest. Support crew, if any, may only assist rider at checkpoints. Traffic laws must be obeyed. Each rider is considered to be on a private excursion and is responsible for accidents caused. See www.rusa.org for full brevet rules.

Important! - 400km, 600km, and 1000km are subject to cancellation. Pre-registration is required -- pre-registration allows us to gauge whether there are enough participants to hold the brevet, and to notify you in case of cancellation.

Instructions - Print this form, fill it in, and send it (with check for RMCC membership if needed) to: Rocky Mountain Cycling Club, c/o Catharine-Guy Lookingbill, 2756 West 107th Court #A, Denver CO 80234 or, if you are already an RMCC member you may register by e-mail by sending an e-mail indicating which events (with DATES -- for example '300km brevet on July 28th') you are applying for, to Colorado Regional Brevet Administrator.