Welcome to the Santa Barbara Century - October 23, 2010

Registration Information
CENTURY and METRIC CENTURY

October 23, 2010

Important Note: Registrations are limited to the first 1000 riders.

Finisher's awards for riders registering after October 1 may be mailed rather than be available at the finish.

Click here to register online with active.com (processing fee added)

Click here for a printable PDF registration form

               It is very important to print legibly!

Last Name: ____________________________________________

First Name: _________________________  Middle Initial: ______

Street Address: _________________________________________

City: _____________________________  State: ____  Zip: ______

Telephone (with area code): ________________________

Email Address: __________________________________________

Birthdate:  Month ___  Day ___  Year ___     Gender ___

Emergency Contact: __________________  Telephone: __________

Ride (check one):  Century  ___   Metric Century ___

If riding tandem, name of partner: ____________________________
(both riders must complete separate registration forms)

Cost if mailed by October 1: $65    Cost if mailed after October 1:  $85 

Check Enclosed: _______

 Waiver, Release and Indemnity

I, the undersigned, for myself, my relatives, my heirs, executors, administrators and assigns, waive and release any and all claims for damages, for death, personal injury or loss of property which I may have or which may hereafter accrue to me against the sponsors of this event, the organizers and any promoting organizations, property owners, law enforcement agencies, all public entities and special districts, through or by which the event will be held for any and all damages which may be sustained by me directly or indirectly in connection with the event, or travel to or return from the event.  I further agree to save and hold harmless the Santa Barbara Century, its officers, directors, and volunteers from any and all liability for any injury or damage resulting from, or in any way connected with, my participation in this ride.

I acknowledge that this event contains risks and dangers.  Some of these include but are not limited to traveling on or crossing heavily traveled roads, winding roads, steep descents, potholes, accidents, unexpected moves of another rider, physical exertion, fatigue, flat tires, and motorists. 

I attest that I am sufficiently trained for my participation in the selected event.  I recognize that an event of this nature can be physically demanding.  I acknowledge the sponsor's recommendation that I consult with a physician regarding the advisability of my participation in this activity.  I further acknowledge that no special arrangements have been made with regard to the conditions of the roads or to to controlling vehicle traffic on the roads that comprise the bike route.  I attest that the equipment that I will use in this event is in good mechanical condition, and that wearing a bicycle helmet is required during this event.

I give to the Santa Barbara Century, Inc., its designees, agents and assigns, unlimited permission to use, publish and republish in any form or media, reproductions of my likeness (photograph or video) with or without identification of me by name.  I agree to not demand payment or any other compensation and agree to hold the above parties harmless of all liability arising from such use.

I have read and understand everything written above, and I voluntarily sign this agreement.

Signature of participant: ___________________________________  Date: ________

Signature of parent or guardian: _____________________________  Date: ________
(for riders under the age of 18)

Mail to: Santa Barbara Century, PO Box 50514, Santa Barbara, CA 93108