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2010 ABD CYCLE CLUB INDOOR/OUTDOOR TIME TRIAL SERIES
For race information or to register online, go to
NAME (last name 1st):
CLUB (if applicable) :
Racing Age 2010:
LE FOR MATTS)
c One in each c
or Specific Start
( uniors <1
5, please indicate
a if you’
d lik to ra
5k or 10k)
NUMBER OF RACES _______ x $25 per race (Juniors $12)
add $3 late fee if within one week of an event ** See Discount Below**
2nd RACES OF DAY _______ x $17 per race ** See Discount Below**
Series Discount Deal!!
for al 4 races for just $80 ($20ea.), Juniors race al 4 for
$45; Race 2nd Category @ ALL 4 races NOW
for $15 per race ($60) TOTAL
To Register for the 2010 ABD TT Series send completed form along with check or money order payable to:
ABD Cycle Club, 17W461 Hill St., Villa Park, IL 60181
ENTRIES MUST BE RECEIVED AT LEAST 7 DAYS BEFORE THE EVENT- ANY ENTRIES RECEIVED WITHIN 7 DAYS
OF THE EVENT WILL NOT BE PROCESSED!!!
2010 Accident Waiver and Release of Liability
I acknowledge that this athletic event is an extreme test of a person's physical and mental limits and carries with it the potential for death, serious injury
and property loss. The risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of athletes, equipment,
vehicular traffic, actions of other people including, but not limited to, participants, volunteers, spectators, coaches, event officials, and event monitors,
and/or producers of the event, and lack of hydration. These risks are not only inherent to athletics, but are also present for volunteers. I hereby assume
al of the risks of participating and/or volunteering in this event. I realize that liability may arise from negligence or carelessness on the part of the
persons or entities being released, from dangerous or defective equipment or property owned, maintained or control ed by them or because of their
I certify that I am physical y fit, have sufficiently trained for participation in the event and have not been advised otherwise by a qualified medical person.
I acknowledge that this Accident Waiver and Release of Liability (AWRL) form wil be used by the event holders, sponsors and organizers, in which I may
participate and that it wil govern my actions and responsibilities at said events.
In consideration of my application and permitting me to participate in this event, I hereby take action for myself, my executors, administrators, heirs, next
of kin, successors, and assigns as fol ows: (A) Waive, Release and Discharge from any and al liability for my death, disability, personal injury, property
damage, property theft or actions of any kind which may hereafter accrue to me or my traveling to and from this event, THE FOLLOWING ENTITIES OR
PERSONS: American Bicycle Racing, Inc., Community Middle School District 34, their directors, officers, employees, volunteers, representatives, and
agents, the event holders, event sponsors, event directors, event volunteers; (B) indemnify and Hold Harmless the entities or persons mentioned in this
paragraph from any and al liabilities or claims made by other individuals or entities as a result of any of my actions during this event.
I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident and or il ness during this event.
I understand that at this event or related activities, I may be photographed. I agree to al ow my photo, video or film likeness to be used for any legitimate
purpose by the event holders, producers, sponsors, organizers and or assigns.
This AWRL shal be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.
I hereby certify that I have read this document; and, I understand it's content.
Signature of entrant:_________________________________________________________ ABR member number: ______________
Name of event : ABD 2010 Indoor Time Trial Series
Date of events: 1/24/10 Indoor TT #1 2/21/10 Indoor TT #2
(any event you participate in on the above date(s) is covered by this single waiver )
Name, printed:___________________________________________________________________________________ ____________
Your address:________________________________________________ City, State & Zip:_________________________________
Your Phone Number:__________________________________________ Email Address:________________________________
Cal in case of emergency:________________________________________________
Ability Category Entered: ___________________ OR
Age Group Entered: _____________________ Racing Age:_________
Racing club: ______________________________ (if none enter “Unattached”)
PARENT GUARDIAN WAIVER FOR MINORS (Under 18 Years Old)
The undersigned parent and natural guardian or legal guardian does hereby represent that he/she is, in fact, acting in such capacity and agrees to save
and hold harmless and indemnify each and al of the parties referred to above from al liability, loss, cost, claim or damage whatsoever which may be
imposed upon said parties because of any defect in or lack of such capacity to so act and release said parties on behalf of the minor and the parents or
Signature of Parent of Guardian___________________________________________________Date____________________________
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FEVER MANAGEMENT IN CHILDREN DESCRIPTION- A fever means the body temperature is above normal. Your child has a fever if his: axillary (armpit) temperature is over 99.00 F The body’s average temperature when it is measured orally is 98.60 F, but it normally fluctuates during the day. Mildly increased temperature (100.4 to 101.30 F) can be caused by exercise, excessive clothing, a hot