NUMB 2020 Waiting List

Thank you for your interest in NUMB 2020 - as spots open on NUMB 2020 we will move your information over to the Registered list and you will receive a confirmation email at that time with a link to pay for your registration fee - $55 - After April 14th the fee is $60.

If you have any questions, don't hesitate to contact us. Regina Bergman Registrar regina@numbride.org

*First Name
*Last Name
*Email
*Preferred Name for nametags, etc.
*Address
*City
*State
*Zip Code
Cell Phone #
Home Phone #
*Date of Birth
*Age (as of 6/27/2020)
*Gender
Male
Female
*May all information be sent via email?
Please make sure to add regina@numbride.org and info@numbride.org into your address book so that it does not go into junk mail.
Yes
No
*T-Shirts
Each rider receives one t-shirt upon registration. If you would like additional t-shirts they are $10 each.
Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult XX-Large
Extra T-shirt Order ($10) Please fill in the number of extra -shirts you would like to order.
Only number values are allowed
Size(s) of Extra T-shirt ordered
Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult XX-Large
United Methodist Church Please indicate the Great Plains United Methodist church name and location you would like your donations to be credited to (if applicable)
Saturday Optional Morning Ride

Please indicate if you will be there to ride on Saturday. Camping is available in Elkhorn on Friday and Saturday evening. If you do not know at this time if you will be at the saturday ride, you can let us know when the date gets closer.

Yes
No
No answer
*This is my first NUMB!
Yes
No
If this is not your first NUMB, how many NUMB rides have you participated?
*Type and make of bike. This information is to help our mechanics to have supplies available. If you are volunteering, please write volunteer.
I would like to volunteer! I won't be riding, but I would like to help with support (No fee is charged for volunteers, you will be sent additional information! Thanks for volunteering!
Note:
In case of emergency - please contact:
Last/First
*Relationship to you:
*Best phone number for emergency contact:
I agree to the terms and conditions outlined below.

I, the undersigned, freely acknowledge and realize the dangers in participating in NUMB ‘20 and fully assume all risks including but not limited to, collision with pedestrians, vehicles, other riders, and/or fixed or moving objects, the negligence of other riders, sponsors, promoters or drivers and dangers arising from falls, road surface, equipment failure, inadequate safety equipment, weather conditions, as well as the possibility of physical and/or mental trauma (or injury). I understand that the route requires bicycling on public roadways and in bad weather and that cyclists have been hospitalized and/or killed because of traffic mishaps that are either their responsibility or others’ responsibility, and I further agree that I will bear all expenses incurred in any such accidents.

  I realize that NUMB requires physical conditioning and I represent that I am in sound medical condition. I have no physical or medical impediment, which would endanger others or myself. I understand and agree that a situation may arise during NUMB which may be beyond the control of the sponsors, promoters, or organizers and agree to ride so as not to endanger either others or myself.

  I waive, release, discharge for myself, my heirs executors, administrators, legal representatives (including successors), any and all rights and/or claims which I have, may have, or may hereafter accrue to me against the sponsors and promoters of NUMB including the United Methodist Conference or other sponsors or affiliated organizations and their respective agents, officers and employees for any and all damages, injuries, or claims which may be sustained by me directly or indirectly arising out of my participation in NUMB

  Participant agrees to indemnify and hold the organizer harmless and to indemnify the organizer for all claims that may arise from the participant's Injuries or death or property damage caused by the simple negligence of the organizer.

  The above agreements and representations are my express understandings of the risks, and I assume these voluntarily and freely without coercion or duress. This agreement may not be modified orally and may not be waived in any respect. I accept responsibility for the condition and adequacy of my bicycle and agree to abide by the rules of NUMB relating to the wearing of a helmet as well as other organization requirements.

  I authorize the use of my name, photos or videos of myself to be used by NUMB or any associated organization for the purpose of promoting NUMB and I hereby disclaim any and all rights to such photos or videos. There is no time limit in hours, days or years that my photo image may not be used. I also understand NUMB will only use my photo or image in publicity related to NUMB.

*Rider information list. By checking yes you give permission to include your name, address and email on a rider list to be given to all riders on NUMB 2014 at check-in. If you check no - we will not include you on the list.
Yes
No
For those 18 years and under:
Person responsible for minor on NUMB 2020

If you are a minor (under age 18), please list the person that will be responsible for you on NUMB 2020. This is required of all under 18 years of age.

Parent/guardian permission.

I have the permission and consent of my parent(s) and/or guardian to participate in NUMB 2020. I further agree that my parent(s) and or guardian(s) agree to the terms described above. A waiver will be sent to you to have both parents sign and bring with you to NUMB check-In.

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