Ride for the Cause - Registration-Word (00694784-2)

Lifestyle Family Fitness “Ride by the Bay” 2007 November 17, 2007, 8:00am-12:00pm “In the BayWalk Courtyard” Come join Lifestyle Family Fitness for a morning of riding for a great cause – the Leukemia & Lymphoma Society. Giveaways, food, music and of course...fitness! Sign up to ride for 30-minute sessions, up to a maximum of 2 hours, with your favorite RPM and Cycle instructors from all Pinellas County Lifestyle locations! Please be at BayWalk prepared to ride at least 10 minutes prior to your time slot. Registration Fees: $15 for each 30 minute session. All registration fees go directly to the Leukemia & Lymphoma Society.

 Registration is first come, first served. Deadline for registration is November 14, 2007.  Please make checks payable to Leukemia & Lymphoma Society.  Registration Forms and checks must be brought or mailed to: The Sembler Company c/o Alissa Mitchell, Event Planner – BayWalk 5858 Central Avenue St. Petersburg, FL 33707

For additional details, call Alissa Mitchell (727) 204-0299, or email Marcy Stuck at [email protected].

Name______Gender______Age_____ DOB______

Street Address ______City______Zip Code______

Phone (Day)______(Evening) ______

E-mail address______

Lifestyle Member Yes  No If yes, home club? ______

Time Slot Preference: 8:00- 8:30 _____ 8:30- 9:00 _____ 9:00-9:30 ______9:30-10:00 _____ 10:00-10:30 _____ 10:30- 11:00 ______11:00-11:30 _____ 11:30-12:00 _____

Please Note: You can request up to 4 time slots (using 1 – 4) depending on how many sessions you would like to ride. Time slots are on a first come, first served basis and are not considered confirmed until receipt of donation check and confirmed email reply.

Participant Waiver

I, ______, a Lifestyle Family Fitness Ride by the Bay participant, acknowledge that I am assuming all risks of injury that might result from participation. I realize that this event will take place outdoors and involves physical activity. I certify that I am in good health and physically able to participate. I agree to waive any claims or rights I may otherwise have toward Lifestyle Family Fitness and BayWalk, their owners, officers, employees, agents or event volunteers.

Participant Signature______Date______