2023 Covered Bridge Ride Choose Your Registration Type:(Required) Rider ($50) Rider & Passenger ($90) Sponsor ($250) Name(Required) First Last Business Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code 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 Country Email(Required) Are you planning to ride in the Event? Yes No I would like to be a Road Guard Course Leader (we will meet prior to run the route) Waiver for Rider(Required) I agree to the liability waiver.The undersigned desiring to enter and participate in the Covered Bridge Ride does herby tender his/her application. In consideration of this application the undersigned does hereby 1) Release Oxford Area Chamber of Commerce and all respective staff, volunteers and agents from any and all liability arising from the event. 2) Release all other participating business facilities and participants from any and all liability from events. 3) Give permission to use any photographs or information obtained prior to and at the event for publication advertising and video filming of the event and 4) Agree to have vehicle liability insurance required by the State of Pennsylvania. I have read and accepted the term and conditions. Name of Rider(Required) First Last Waiver for Passenger(Required) I agree to the liability waiver.The undersigned desiring to enter and participate in the Covered Bridge Ride does herby tender his/her application. In consideration of this application the undersigned does hereby 1) Release Oxford Area Chamber of Commerce and all respective staff, volunteers and agents from any and all liability arising from the event. 2) Release all other participating business facilities and participants from any and all liability from events. 3) Give permission to use any photographs or information obtained prior to and at the event for publication advertising and video filming of the event and 4) Agree to have vehicle liability insurance required by the State of Pennsylvania. I have read and accepted the term and conditions. Name of Passenger(Required) First Last How would you like to receive your T-Shirts Please Mail them to me I'll coordinate a time to pick them up from the Chamber Office I do not want my t-shirts, so you can donate them to someone else Choose Rider's T-ShirtPlease select Your T-Shirt sizes from the lists below. It is recommended to order a size up in the ladies V-neck T-Shirt.Men's Crew Neck SmallMen's Crew Neck MediumMen's Crew Neck LargeMen's Crew Neck XLMen's Crew Neck 2XLMen's Crew Neck 3XLMen's Crew Neck 4XLWomen's V-Neck XSmallWomen's V-Neck SmallWomen's V-Neck MediumWomen's V-Neck LargeWomen's V-Neck XLargeWomen's V-Neck 2XLWomen's V-Neck 3XLWomen's V-Neck 4XLChoose Passenger's T-ShirtPlease select your Passenger's T-Shirt It is recommended to order a size up in the ladies V-neck T-shirt.Men's Crew Neck SmallMen's Crew Neck MediumMen's Crew Neck LargeMen's Crew Neck XLMen's Crew Neck 2XLMen's Crew Neck 3XLMen's Crew Neck 4XLWomen's V-Neck XSmallWomen's V-Neck SmallWomen's V-Neck MediumWomen's V-Neck LargeWomen's V-Neck XLargeWomen's V-Neck 2XLWomen's V-Neck 3XLWomen's V-Neck 4XLSponsor, please upload your logoMax. file size: 256 MB.Total Payment MethodCredit Card MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Expiration Date Security Code Cardholder Name CommentsThis field is for validation purposes and should be left unchanged.
