TOUR DE UPLAND
Saturday, August 20, 2011
8:00 A.M.
30 Hours of cycling, beer, music and camping in Nashville, Indiana!
15,31,47,82 MILE ROAD ROUTES
6-30 MILE MOUNTAIN BIKE ROUTES
Start/Finish
Camp Framasa
2230 N. Clay Lick Rd.
Nashville, Indiana 47448
Participants must be 21+ years old
$90.00 Early Registration
(includes bike tour, lunch, dinner, camping, and breakfast on Sunday morning)
Early registration is due by June 1, 2011
$115.00 if paid from June 2nd-August 10th
Late Registration is $150.00
Late Registration runs from August 11th-Event Day. Event day reg opens at 6:30 a.m. on event day
Late Registration is available only if the event is not full - limit 400 participants
Name:
Address:
City:
State:
Phone:
E-mail:
 | ||||||
Zip:
I understand and acknowledge that participating in this cycling and camping event may expose me to dangers from both unknown and anticipated risks. I understand that during the bike tour, the course is not closed to traffic and that I could be at risk from traffic, other cyclists, bad weather, steep inclines, steep downhills, rough road and rough terrain along the course. I attest and verify that I am over 21 years of age, am physically fit, and have successfully trained for the completion of this event and my physical condition has been verified by a licensed medical doctor. In consideration of the foregoing, I, for myself, my heirs, executors and administrators, waive and release any and all rights and claims for any claims for damages against any of the sponsors, volunteers, organizers, State of Indiana, Brown County State Park, Brown County, Camp Framasa, The Upland Brewing Co., Inc., Energy2Action, LLC and Bikejerseys.com, for any and all claims of damages, demands or loss actions whatsoever which may arise as a result of my participation in this event. I understand that this event may be canceled or delayed for any legitimate purpose or reason and that my entry fee will not be refunded under those circumstances or for any other reason. Further, I grant full permission to The Upland Brewing Co., Inc. , Energy2Action, and Bikejerseys.com to use any pictures of me for the purpose of promoting the Tour de Upland event and any other legitimate purpose.
Age on Event Day ( Must be 21+ to register for this event):
(Riders are not obligated to complete the distance indicated here. This is for information for our planning only.)
Are you a Road Rider or a Mountain Biker?:
5 UPLAND JERSEYS AVAILABLE FOR $79.00
Click here to see the Jerseys
Click here for the sizing chart
European sizes run MUCH smaller. Make sure you order the right size.
UPLAND Short Sleeve Jersey ($79.00 Extra)
Which Style?:
Size?:
MAIL IN REGISTRATION
Emergency Contact Day of Event:
Phone:
How Did You Hear About Tour de Upland?:
Anticipated Distance:
Do You Want a SECOND Jersey? Another $79
(but it's only money!)
Which Style?:
Size?:
Jerseys that are ordered on line will be SHIPPED to your home PRIOR to the event. Do you want the jersey shipped to the address above? If No, please list the name and address to which the jersey should be sent below:
Food:
Sleeping:
PRINT, FILL OUT AND MAIL TO:
Energy2Action, LLC
1223 Oak Lane
Shelbyville, IN 46176
Signature:
Date:
Make Checks payable to : Energy2Action, LLC
Amount Enclosed:
$115 if Received 6/2/11-8/20/11
$150 if Received after 8/20/11
*If your registration is received late with the incorrect fee it will be mailed back to you.
