Participation and Registration Form

Your Name*

First NameLast Name

Address

E-mail*

Phone Number*

Area CodePhone Number

Date of Birth*

MonthDayYear

Gender*

Registering for:*

(*) Denotes confirmed Miles of Trees Riders.

Suggest other

Your fund raising goal*

IMPORTANT ! Once you register for a ride and communicate to us your participation to the benefit of CDI/Miles of Trees, we will create your personal donation page. All pages will collectively be promoted via CDI general outlets. You will be encouraged and expected to personally share your page and to solicit donations within your own network.

Please detail your level of experrience riding or running. How often and how far do you run or ride ?

Please provide a short blurb about you to be included on your individual Miles of Trees pledge web-page (why do you participate? What inspires you?)*

Send us a picture of you to include in your individual pledge web-page and other promotional material.*

Are you a member of a bike club or association?

If yes, please tell us which one

Do you have any health concerns or food allergies?*

If yes, please tell us which one

Rules: All rides except the Miles of Trees Ride from VA Beach to NYC are third-party events. As such, participants must register with the organizer and pay all registrations fees as applicable. Participants in those rides must adhere to all rules stipulated by the organizer. CDI/Miles of Trees is not responsible for accidents, injuries, damage or loss of equipment. Under no circumstances will CDI/Miles of Trees allow riders to wear headphones or to not wear a helmet while riding.

Miles of Trees FLAGSHIP RIDE: Participation in this ride is subject to a minimum of $500 fund raising requirement. This covers all ride expense, accomodation along the route, food, drink, medical and emergency support, as well as the cost of the Miles of Trees cycling jersey. This does not cover your travel to/from start/end location or any accomodation beyond three nights along the four-day rote. For all other rides CDI/Miles of Trees does not set a fund raising minimum, and you may set your own goal to be included on your personalized donation page.

I agree to the rules and stipulations. I will ride at my own risk and will not hold CDI/Miles of Trees responsible for any personal injury or damage of physical property.

Signature

Miles of Trees - 2013 Participation & Registration Form