Do not complete this form until your group registration and payment have been accepted!

Items marked with an "*" require a response.

PERSONAL INFORMATION (Part 1 of 5)

Distribute My Contact Information to Other Participants*
(your contact information will only be distributed to other participants and not to anyone else)
Yes No

Food Considerations You May Need
(food allergies, lactose intolerant, vegetarian/vegan, Kosher, etc.)

Additional Considerations You May Need
(special lodging requirements, travel plans, boxed bike shipments, transportation of bike trailers or shipping containers, CPAP machine, disability accommodations, etc.)

How Did You Hear About Our RAGBRAI Transportation Service?

What phrase(s) would you type into an internet search engine such as Google and Yahoo to find us?
(this is to optimize our internet search results)

PERSONAL TRAVEL AND LODGING (Part 2 of 5)

EXTRA SERVICES AND MERCHANDISE (Part 3 of 5)

If your group leader did not include the following extra services and merchandise items on your group registration you will need to purchase them on your own.

• Click Here to add extra service or merchandise items if they were not included in your group registration.

Extra Services

Bicycles That Require Special Handling and Care - $30.00 one way
There will be an additional fee to transport recumbents, e-bikes, and tandems. However a tandem bicycle will not incur an additional fee if both people riding it register for the same transportation service. Trikes (any bicycle with three or more wheels) are not allowed because we cannot easily and quickly transport them in any support vehicle.

• Click Here for more information about transporting bicycles that require special handling and care.

Merchandise Items
The following merchandise items are avialable for purchase. All merchandise items will be delivered during the event.

• Bicycle Illinois Jerseys
• Bicycle Illinois Water Bottles
• Bicycle Illinois Baseball Hats
• Extra Bicycle Illinois T-Shirts
• Bicycle Illinois Polo Shirts
• RAGBRAI: America's Favorite Bicycle Ride Book

YOUR EVENT INTERESTS (Part 4 of 5)

Please indicate your level of interest in our other events.

Bicycle Illinois' AGREEMENT, WAIVER & RELEASE OF LIABILITY for the RAGBRAI Transportation Service
(Part 5 of 5)

Bicycle Illinois is only providing transportation service as described on www.bicycleillinois.com for participants, their bicycles, and/or their baggage to the start of RAGBRAI and/or from the end of RAGBRAI per individual registration and not providing any other services.

I, the undersigned, know that the RAGBRAI TRANSPORTATION SERVICE ("the SERVICE") and the RAGBRAI event itself is a potentially hazardous activity and I attend it out of my own free will and choice. In choosing to participate in the SERVICE, I fully accept and assume all risks, whether before, during or after the SERVICE. These include, without limitation, physical injury, mental injury, emotional distress, trauma, sickness, illness, death, contact with other people or objects, equipment failure, inadequate safety equipment, the effects of weather including extreme temperature or conditions, and the conditions of traffic and off the road. All risks are known and appreciated by me. I shall assume and pay my own medical and emergency expenses in the event of injury, illness, or other incapacity regardless of whether I authorized such expenses.

I agree to abide by all of the SERVICE rules, regulations, policies and procedures as published on www.bicycleillinois.com and/or as directed by the ride director and that my participation in the SERVICE may be temporarily or permanently terminated for any failure to do so. I realize that participation in the SERVICE requires physical conditioning and I represent that I am in sound medical condition capable of participating in the SERVICE without risk to myself or others. I have no medical impediment, which would endanger others or myself. I understand and agree that a situation may arise during the SERVICE which may be beyond the control of Bicycle Illinois. I will be solely responsible for the condition and adequacy of my personal gear and equipment. I will participate safely within the limits of my own abilities, my equipment, and the conditions, and in a manner so as not to endanger either myself or others.

I grant Bicycle Illinois the unrestricted right, license, and authority to display, record, and/or otherwise use my image, voice, likeness and/or any depiction of mine in whole or in part for any purpose at Bicycle Illinois's sole discretion, including, but not limited to, any account, description, picture, video, audio, reproduction or other information related to the SERVICE.

Knowing these facts and in consideration of my entry acceptance, admission to and/or participation in the SERVICE, I, for myself and anyone acting on my behalf, release, waive, discharge, covenant not to sue and agree to hold harmless Bicycle Illinois and any of its sponsors and participating clubs, communities and organizations, officials, emergency and support personnel, volunteers, directors, employees, representatives, agents, and successors of all of the above, from any and all claims, demands and actions of any and every kind I have, may have or may hereafter accrue against the released parties directly or indirectly arising out of or relating in any respect to my attending or participating in the SERVICE. My waiver and release of all claims, demands, actions and liability shall include without limitation, any injury, damage or loss to my person or property which may be (a) caused by any act, or failure to act, by the above-identified persons and entities or (b) sustained by me before, during or after the SERVICE. I further agree to indemnify and hold Bicycle Illinois harmless from any and all losses, damages, claims and expenses, including attorneys' fees, arising from or relating in any respect to my participation in the SERVICE or my breach of this agreement. If I am a minor, my parent or guardian also is signing on my behalf and we both agree to be bound by the terms of this agreement, waiver and release.

You will receive a confirmation phone call or e-mail and additional, more specific event information later. We may also contact you for additional information or specific volunteer opportunities, particularly if you will park your car in one of the stopping towns. Unless specifically requested, you will not receive a confirmation package or any printed materials in the mail. All registration items (cue sheets, t-shirts, etc.) will be distributed on site during the event. If you have any questions at all regarding your registration, please feel free to contact us at any time.

Please continue to check for updates on bicycleillinois.com for the most current event information.

Thank you for your purchase, we look forward to seeing you on the event!

Sincerely,

Robert S. Layton
Ride Director

After you submit this form, you will be redirected to the RAGBRAI Transportation Service home page. Thank you very, very much for your registration!