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| Pre-Registration Form (Step 1 of 3) |
| City / Department: |
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Rank: |
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| First: |
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Last: |
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| Address: |
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| City: |
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State: |
Zip: |
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| Phone: |
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Email: |
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| Cell Phone: |
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Competitor's Email Decision Maker's Email |
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| Distance Traveled: |
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Did you compete last year?:
Yes No |
| Number of years competing: |
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| Motorcycles competing: |
BWM Harley Kawasaki Other If other, please specify: |
| Will you be sharing motorcycles with another officer? |
Yes No |
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| Number of years experienced as officer: |
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| Number of years on motorcycle: |
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| Are you an instructor?: |
Yes No |
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| Fee Structure: |
| Prior to May 4: |
$25 |
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After May 4: |
$30 |
| Includes: |
Challenge Coin
1 Drawing Ticket
Box Lunch |
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Includes: |
Challenge Coin
1 Drawing Ticket |
| Competition Terms and Conditions: |
By registering, I understand the CO Chapter 1 is afiliated with the "Blue Knights International" but it remains a seperate, independent entity, solely
responsible for its actions. I also agree that CO Chapter 1 shall not be liable or responsible for damage to property or any injury to person, including myslef, during Chapter
activities, even when the damage or injury is cause by negligence (except willful neglect). I understand that, and agree, that I am participating voluntarily
and at my own risk in this event. I release and hold the Blue Knights, CO Chapter 1, it's additional insured and it's officers harmless for any injury or loss to my property or person,
which may result therefrom. I understand that this means that I agree not to sue the Blue Knights CO Chapter 1 in connection with any chapter events or activity.
I agree to the above terms and conditions. |
Verification Code: |
Change Image (Please verify the image letters ) |
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