ETR 2024 Registration "*" indicates required fields 1Team2Captain3Stoker4Address5Sunday Lunch (Optional)6Legaleze7Finish + Pay Registration + Lodging*The rally registration fee ($350) includes: Friday evening ice cream social; Saturday lunch at The Hickory Bridge Farm & Saturday evening buffet (seafood, meat & vegetarian) dinner. You will need to make your own lodging reservations whether they be at the Wyndham Gettysburg Hotel or off site. Note: The negotiated ETR rate at the Wyndham Gettysburg includes breakfast Saturday and Sunday morning. We will be staying at the Wyndham Gettysburg We will NOT be staying at the Wyndham Gettysburg Adult Guests*Two Adults ($350)Three Adults ($525)Is this your first ETR?* Yes No Captain's Name* First Last Captain's first and last name as it should appear on your name badgeIf left blank we'll use the First and Last name above. Captain's Email* Captain's Cell Phone*Captain's Saturday Lunch (Included)*Saturday buffet lunch will include Fresh Fruit Salad, Green Salad, Old Fashioned Potato Salad, Chips & Pretzels, Desserts, Beverages and your choice of: Mediterranean Sandwhich or Turkey with Havarti Cheese. Mediterranean Sandwich (Organic whole grain, hummus, pesto, cucumber, red onion, red peppers & feta) Turkey with Havarti Cheese (Whole wheat sandwhich thin, turkey, havarti cheese, baby spinach, chipotle mayo) Substitute Gluten Free Bread?* No Yes Captain's special dietary needs Stoker's Name* First Last Stoker's first and last name as it should appear on your name badgeIf left blank we'll use the First and Last name above. Stoker's Email Stoker's Cell PhoneStoker's Saturday Lunch (Included)*Saturday buffet lunch will include Fresh Fruit Salad, Green Salad, Old Fashioned Potato Salad, Chips & Pretzels, Desserts, Beverages and your choice of: Mediterranean Sandwhich or Turkey with Havarti Cheese. Mediterranean Sandwich (Organic whole grain, hummus, pesto, cucumber, red onion, red peppers & feta) Turkey with Havarti Cheese (Whole wheat sandwhich thin, turkey, havarti cheese, baby spinach, chipotle mayo) Substitute Gluten Free Bread?* No Yes Stoker's special dietary needs Address* Street Address City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Emergency Contact Name* First Last Emergency Contact Phone* Captain's Sunday Box Lunch (Optional)*Sunday Box lunch - $25. Each lunch includes: Sandwich (choice), Apple, Utz Chips, Cookie & Bottled water.No Sunday LunchRoasted Turkey Breast/ Wheat Bread (Smoked Provolone, Leaf Lettuce, Tomato,and Pesto Mayonnaise)Vegetable/ Spinach Wrap (Marinated Zucchini, Yellow Squash, Red Pepper, and Red Onion Hummus, and Balsamic Glaze)Roast Beef/ Tortilla Wrap (Shaved Roast Beef, Smoked Provolone, Red Onion, Leaf Lettuce, and Horseradish Mayonnaise)Stoker's Sunday Box Lunch (Optional)*Sunday Box lunch - $25. Each lunch includes: Sandwich (choice), Apple, Utz Chips, Cookie & Bottled water.No Sunday LunchRoasted Turkey Breast/ Wheat Bread (Smoked Provolone, Leaf Lettuce, Tomato,and Pesto Mayonnaise)Vegetable/ Spinach Wrap (Marinated Zucchini, Yellow Squash, Red Pepper, and Red Onion Hummus, and Balsamic Glaze)Roast Beef/ Tortilla Wrap (Shaved Roast Beef, Smoked Provolone, Red Onion, Leaf Lettuce, and Horseradish Mayonnaise) Waiver*RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, INDEMNITY, AND PARENTAL CONSENT AGREEMENT ("Agreement") for LEAGUE OF AMERICAN WHEELMAN D/B/A LEAGUE OF AMERICAN BICYCLISTS ("LAB") (this form is to only be used for Individual Adults or for Adults on behalf of Minors) IN CONSIDERATION of being permitted to participate in any way in Eastern Tandem Rally ("Club") sponsored Bicycling Activities ("Activity") I, for myself, my personal representatives, assigns, heirs, and next of kin: 1. ACKNOWLEDGE, agree, and represent that I understand the nature of Bicycling Activities and that I am qualified, in good health, and in proper physical condition to participate in such Activity. I further acknowledge that the Activity will be conducted over public roads and facilities open to the public during the Activity and upon which the hazards of traveling are to be expected. I further agree and warrant that if, at any time, I believe conditions to be unsafe, I will immediately discontinue further participation in the Activity. Client assumes all risks, safety and liability concerning COVID-19. 2. FULLY UNDERSTAND that (a) BICYCLING ACTIVITIES INVOLVE RISKS AND DANGERS OF SERIOUS BODILY INJURY, INCLUDING VIRAL INFECTIONS, BACTERIAL INFECTIONS AND OTHER COMMUNICABLE DISEASES AND ILLNESSES, PERMANENT DISABILITY, PARALYSIS AND DEATH ("Risks"); (b) these Risks and dangers may be caused by my own actions or inactions, the actions or inactions of others participating in the Activity, the conditions in which the Activity takes place, or THE NEGLIGENCE OF THE "RELEASEES" NAMED BELOW; (c) there may be OTHER RISKS AND SOCIAL AND ECONOMIC LOSSES either not known to me or not readily foreseeable at this time; and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I may incur as a result of my participation in the Activity. 3. HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE the Club, the LAB, its respective administrators, directors, agents, officers, members, volunteers, and employees, other participants, any sponsors, advertisers, and, if applicable, owners and lessors of premises on which the Activity takes place, (each considered one of the "RELEASEES" herein) FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON MY ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE "RELEASEES" OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS. And, I FURTHER AGREE that if, despite this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT I, or anyone on my behalf, makes a claim against any of the Releasees, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES from any litigation expenses, attorney fees, loss, liability, damage, or cost which any may incur as the result of such claim. 4. Eastern Tandem Rally “Club” discourages the usage of Class 2 electric bikes during Club activities. The Model Electric Bicycle Law defines Class 2 electronic bikes, as follows: an electric bicycle equipped with a motor that may be used exclusively to propel the bicycle, and that is not capable of providing assistance when the bicycle reaches the speed of 20 miles per hour. I, the undersigned, understand and acknowledge that Class 2 electric bicycles are not permittable during Club activities and therefore, accept full responsibility for any injury to myself and/or to other members of the Club, participants of any Club activity, individuals unrelated to the Club and to the Club itself for any loss or damages arising from the use of a Class 2 electric bicycle during a Club activity. Further, I hereby release, discharge and covenant not to sue the Club, its respective administrators, directors, agents, officers, members, volunteers, employees, other participants, sponsors and if applicable, owners and lessors of premises on which the Club activity takes place (releasees) caused by my use of a Class 2 electric bicycle during this ride for injuries that occur while riding a Class 2 electric bicycle even if caused by the negligence of any of the releasees. I have read and understand this Acknowledgement of Electric Bicycles and release of liability and do voluntarily agree to sign. I AM 18 YEARS OF AGE OR OLDER, HAVE READ AND UNDERSTAND THE TERMS OF THIS AGREEMENT, UNDERSTAND THAT I AM GIVING UP SUBSTANTIAL RIGHTS BY SIGNING THIS AGREEMENT, HAVE SIGNED IT VOLUNTARILY AND WITHOUT ANY INDUCEMENT R ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW. I AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID, THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT. LAB MINOR W&R – updated 6-25-2020 mod COVID sentence and Point 4 as per American Specialty Insurances I agree to the waiverRefunds*Prior to April 1, 100% refund less 5% fee April 1 - April 20, 50% refund After April 20, 0% refund. I agree to the refund policyBike Storage* We understand that no bikes will be permitted in the host hotel rooms and there WILL be bicycle storage in the hotel. E-Bikes* We understand that only unmodified Class 1 E-Bikes are allowed at the rally. If you have a Class 2/3 E-Bike or have modified the electronics on your Class 1 in any way, IT IS NOT ALLOWED at ETR. If you are wondering why, it's because of insurance... I grant permission to share names, town, phone and email addresses with the group* Yes No Total NameThis field is for validation purposes and should be left unchanged.