Welcome to the
2012 Bicycle Tour of Colorado
On-Line Registration for a SINGLE RIDER
LIMITED to 1500 CYCLISTS

Please, do not mail or fax this form. It is for the online registration only. The printable BTC registration form is on the BTC Home Page/Registration.

Important!! This is a two part form.

  1. Part 1 is the registration information form. Part 2 is the payment form.
  2. Use the "Print" Button at the end of Part 1 to keep a record of your registration information as you will be required, in Part 2, to select and pay for your tour registration and other items such as parking, in training t-shirt, meals, tour jersey, tour DVD. Once the registration form is submitted, Part 2 will follow for payment.
  3. An e-mail confirmation will be sent to you confirming your registration. A Confirmation Packet will also be emailed to you.
  4. Online Registration may not be used for the "6th Rider Goes Free" offer or with any other discounts.
THANKS FOR YOUR INTEREST IN THE 2012 BTC.


-- All "Text Fields" must have an entry.-----

-- If a field is not applicable please type "None" in the text box. ----

Rider Name: Age: ......Gender: Male Female

Address:

City: State/Province:

ZIP/Postal Code: Country:

Home Phone: Work: Cell:

E-Mail Address*: .... Occupation:

(*Note: e-mail address will be used for registration confirmation, information, and tour rider contact only!!)

Team/Club:

How many yrs. have you ridden the BTC? (Select One)

Complimentary 2012 Tour T-Shirt Size (Select One):

Sm Med Large X-Large XX-Large

Emergency Contact Info:-------------------------------------------------------------------------------------------------------

Emergency Contact: Emergency Contact Phone:

Emergency Contact Relationship:

Emergency Contact Address:

City: State/Province: Country:

ZIP/Postal Code:

Rider Health/Medical: --------------------------------------------------------------------------------------------------------------

Medication Allergies:   No Yes

If you have Medication Allergies please explain/describe here, if not type "None" in box below:

Taking Medications/Currently: No Yes

If you are taking Medications please explain/describe here, if not type "None" in the box below:

Medical Problems/Condition: No Yes

If you have Medical Problems please explain/describe here, if not type "None" in the box below:

Camping/Lodging Choice:--------Please select one of the options below -----------------------------------

Outdoor Camping or I am making my own arrangements (No add'l. charge)

Indoor Camping (Add'l 50.00 Fee)

Tent Service (Contact Shuttleguy at 800-675-2295 for tent reservations, bag transfer, towel service, etc.)

Hotel/Motel (Contact Premier Deliver Service at 303-238-1501 for reservations, and transfer services.)


Meals: --------To ensure your meal availability in each town,make your meal selections below!!!-------- 

----------------------Choose All Meals or one or more combinations of Breakfast, Lunch and/or Dinner.

>----------------------Select Regular or Vegetarian for meal or all meals package.

All Meals (Breakfast 7 Days, Lunch 5 Days, Dinner 5 Days- -Add'l. $309.00)  

Breakfasts (7 Days, including the day off - - Add'l. $109.00) 

Lunches (5 Days - - Add'l. $90.00)  

Dinners (5 Days - - Add'l. $110.00)  

Other Fees:---------------------------Select only the items needed below.-------------------------------------  

Bicycle Box Storage at Start/Finish area (Add'l. $25.00)

Week long Parking Permit - Lot in Fort Collins (Add'l. $35.00) 

In-Training t-shirt to keep you motivated! (Addl. $25)

2012 BTC Regular Sleeved Jersey (Add'l. $69.00)

2012 BTC Sleeveless Jersey (Add'l. $69.00)

2012 BTC Rider Waiver:
WAIVER and RELEASE
Bicycle Tour of Colorado 2012 Release, Waiver of Liability, Assumption of Risk and Indemnity and
Parental Consent Agreement

ANSI or SNELL approved helmets are required. Please read and sign waiver. Riders under 18 must be accompanied by an adult at least 21 years of age.

In consideration of the acceptance of my entry, I, the undersigned participant, for myself, my family members, heirs, administrators, personal representatives, successors and assigns hereby fully release, discharge and hold harmless the Bicycle Tour of Colorado, BTC, Inc., any sponsors, owners and operations of motor vehicles and officers, directors, employees, volunteers and lessors of any of the foregoing persons, or entities from all liability, whether resulting from negligence of any aspect of the BTC and hereby acknowledge that the above persons and entities have no obligation to provide medical care and have not undertaken the responsibility to do so. In the event that I receive medical care as a result of a medical emergency, I hereby consent to such care and fully release the person(s) providing such care from any and all liability, whether resulting from negligence or otherwise. I authorize and consent to persons employed or contracted by the BTC, whether by videotape, film, newsprint, written advertisement or otherwise, of any materials containing my name or picture and I release any sponsors and persons acting under authority from any claims I might have due to initial or subsequent publication of any such materials or photographs. I acknowledge that if my photo or name is used in such materials I will not be receiving any compensation whatsoever. In the event the ride does not take place, or a change occurs in the route due to some unforeseen event, act of God, or any reason beyond the BTC’s reasonable control, the money paid to the BTC will not be refunded. I agree that the BTC is not responsible for lost or stolen items. I hereby certify that I have fully read and understand foregoing release, waiver and covenant not to sue, and sign it voluntarily. I also agree to wear a helmet at all times during the ride. I represent that I have medical insurance. I understand that when five sign up and the sixth is free, there will be no refund of the registration fee when the first cancellation is processed from the group of six. I understand that personal sags are not allowed to stop within one mile before an aid station and within one mile after an aid station. I understand that personal sags are not allowed to park in the designated BTC staff parking areas at the overnight campsite. I have read and understand the waiver and the cancellation policy. I understand my registration is non-transferable. I understand that my registration fee, as well as any other fees are nonrefundable after April 30, 2012 for any reason, work and/or medical included. I have read and understand the waiver and the cancellation policy and sign voluntarily.

Signature __________________________________ Date _____________
Signature of Guardian, if rider is under 18. Guardian must be registered for the 2012 tour.

I agree to and will abide by BTC Waiver and Terms of Participation stated above.

REGISTRATIONS ARE NOT TRANSFERABLE AND THERE ARE NO CARRY-OVERS
NO TRANFERS ARE ALLOWED FOR ANY REASON

2012 BTC Cancellation Policy:

Refund requests must be made in writing and mailed by Postal Mail to the Bicycle Tour of Colorado postmarked by April 30, 2012.
Mail to: BTC PO Box 719, Morrison, CO 80465

Refunds submitted and acknowledged prior to April 30, 2012 will be refunded in full, minus a $75.00 processing fee.

No transfers or carry-overs will be given. No refunds will be given after April 30, 2012 for any reason, medical, work related, or otherwise.

For information on trip cancellation insurance, visit www.mckayinsagency.com.

I understand and agree to abide by BTC Cancellation Policy stated above.

 

<<< Click the button at the left before submitting the form in order to have a record of your registration information.

PLEASE DO NOT PRINT AND SUBMIT THIS FORM VIA MAIL OR FAX TO THE BTC.
THE PRINTABLE FORM IS THE HOME PAGE/REGISTRATION!!!

Please review all of your selections to ensure form is completely filled out before selecting the "Submit Button" below !

After selecting the "Submit" button, you will be taken to the credit card checkout....please wait for it to appear, as it takes a few moments to display.

----------------------- <<This button sends form to BTC Offices!!!