Name ______________________________ Age _____ Gender Male - Female

1. Tour De Delavan Bike Race Registration Form Saturday, August 31, 2013 Start Time: 8:00 a.m. This event will bring you in and around Delavan to enjoy approximately 23 miles of rolling farm country. The sponsors of the race is Little Ades Bicycle Shop and Ragland Buildings . Water stations will be available. All Riders must wear a helmet and supply your own repair equipment. There will be four categories; beginner/Intermediate male/female and advance male/female to win. Trophies will be awarded to the top finishers in each category. Entry Fee is $8.00 for Pre-Registration and $10.00 on Day of Race, please make check payable to “Delavan Fall Festival” Ck #________ Cash ____ Mail all entries to:Phil Anello207 W. 3rd StreetDelavan, IL 61734 All Pre-Registration Entries must be postmarked by August 27th. Registration starts at 7:15 a.m. and race at 8:00 a.m. For additional info. contact Phil Anello at (309) 339-8425 Name______________________________ Age_____ Gender Male - Female Address___________________________________________________________City_____________________________ State_______ Zip______________ Phone______________________ E-Mail_____________________________ Level of Skill: Advanced ____ Intermediate/Beginner ____ In consideration of my entry, I intending bound for myself, my heirs, executors and administrators, waive and discharge any rights and claims against, Delavan Fall Festival Inc., The City of Delavan, and/or any individual or groups involved with the running of these events for any or all injuries suffered by me during these events or while traveling to and from the events. I understand and agree to all the rules and understand that all rulings and decisions of the race officials are final. Signature___________________________ Date_________________