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In signing this form for myself or the above named participants (under 18), I acknowledge that I understand the intent hereof, and I hereby agree to and will absolve and hold harmless the "Back 40 Challenge" directors, Kinetic Systems Bicycles, the Flying Rhino Cycling Club and officers, and any and all other parties connected with this event in any way singly or collectively, from and against and blame or liability for any injury, misadventure, harm, loss, inconvenience, or damage suffered or sustained as a result of participation in the "Back 40 Challenge" or any activities associated therewith. I also hereby consent to and permit emergency treatment in the event of injury or illness. I shall abide by all traffic laws and regulations and will practice courteous and safe cycling.

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T-shirts are pre-order only through May 4th.

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