Attn.: Greg LeMond Bike Ride
Thresholds
4101 North Ravenswood Ave.
Chicago, Illinois 60613

General Information

Please Check One: Individual RiderTeam Rider (five or more)Volunteer
Name (please print):
Team Captain Name (if applicable):
Team Name (if applicable):
Address:
City/State:		Zip+4:
Telephone: (Home)	(Work)	(Fax)
E-mail:	Gender:	Age
T-Shirts (100% Cotton):MLXLXXL
In Case of Emergency, Please Notify:
Name:
Phone on day of ride:

Rider Entry Fee (Non-refundable)
	Individual Riders $35, $45 after 8/15 Team Riders (5 or more) $25, $35 after 8/15 Children 10 and under ride free	$ _____ $ _____ $ _Free_
Please check all appropriate boxes below:
	25-Mile Illinois Loop Ride	25-Mile Milwaukee Loop Ride
	62-Mile Illinois to Milwaukee Ride	62-Mile Milwaukee Loop Ride
	100-Mile Illinois to Milwaukee Ride
	Reserve return bus transportation (Sat. return only)	$ _15__
	Reserve free transportation for my bike back to start (Sat. return only)
	I will be attending the Chicagoland Pre-ride* event ($35)	$ _____
	I will be attending the Milwaukee Pre-ride* event ($35)	$ _____
	*Each team rider (5 or more) registered by 8-15-98 receives a free admission to one of the Friday, September 4th Pre-ride events.
	Total Enclosed:	$ _____
	Enclosed is a check made payable to "Thresholds" Charge the following: VisaMastercard
	Credit Card #: _____-_____-_____-_____ Exp. Date: ___/___
	Signature:

Minimum Pledge Requirement

All Riders must provide credit card information or a hold check for their minimum pledge ($1 a mile.) All pledges are 100% tax deductible. Children 10 and under ride free.

Enclosed is a hold check made payable to "Thresholds" for my minimum pledge of $25, $62, or $100 ($1 a mile). (Please date check for October 16, 1998)

Note: Your hold check will be returned to you after we receive your pledge checks totaling the minimum requirement.

Enclosed is my credit card information:

VisaMastercard to be charged if my minimum pledge requirement is not received by October 16, 1998.
Credit Card #: _____-_____-_____-_____ Exp. Date: __/__
Exp. Date (must be after 10/98)

Signature:

I understand that, if I have not met my minimum pledge requirement by October 16, 1998, my credit card will be charged, or my hold check will be cashed for the outstanding pledge balance.
Please initial:______

Ride Release Form

In consideration of the acceptance in The Greg LeMond Bike Ride and my participation therein, I agree to collect the required pledge minimum (excluding my entry fee) for the benefit of Thresholds, and Curative Rehabilitation Services. In addition, I, my heirs, my personal representatives, or anyone entitled to act on my behalf waive all claims against Greg LeMond, Thresholds, Thresholds Event Marketing Group, Curative Rehabilitation Services, event sponsors, volunteers, municipalities encountered on the route and their employees or agents for any property damage or personal injuries I might suffer in this event. I consent to and permit emergency treatment in the event of injury or illness; I understand that any medical costs incurred will be my responsibility. I grant full permission for all entities named herein to use: my name and address; representations of me in photographs, films and videos; and quotations from me regarding the event. I know that participation in this event could potentially cause injury. I accept all risks associated with participation in this event and agree to practice road safety. I am aware that this event is a ride for enjoyment, not a race. I understand that wearing a helmet is mandatory in order to ride in this event. I am physically fit and prepared for this event. I attest that I am at least 18 years of age. I have read completely and understand this Ride Release Form.

Signature: Date:

Date:
Signature of Parent/Guardian (if entrant is under 18)
I, as a parent or guardian of the named minor, give permission and take full responsibility for my child to participate in this Ride. I have read and fully understand the ride release form

Please Answer the Following Questions: