CANADIAN OILFIELD RIDERS ASSOCIATION 27th ANNIVERSARY
Run for the Children’s Wish Foundation
June 20TH, 2015
Kids of Children’s Wish Overcome Challenges on a Daily Basis
(we will overcome the weather if need be)
All proceeds towards
THE CHILDREN’S WISH FOUNDATION OF ALBERTA & other related charities
ITINERARY
Where: Chestermere (John Peake Park) to Wayne AB
June 20th – 8:00 am – 10:00am Chestermere: Registration & Complimentary Breakfast
10:00am Departure
4:00pm Arrival @ Wayne (Free Camping available)
Wayne Community Hall – Prizes & Dinner, Show & Shine, Entertainment
(Free camping available and encouraged Friday-Sunday for those wishing to depart
Sunday June 21st )
COST
Does it Matter…it’s for the Kid’s
- Pre-Registration Fee = $75.00 per person (Pre-registration fee must be received on or before May 30th, 2015 to
receive 27th Pre-registration gift.)
- Late or On-Site Registration Fee = $75.00 (you may register the day of the event) but you will not receive the 27th
Anniversary gift.
-Commemorative Shirt for first 250 Riders
-There will be NO further solicitation the day of the ride for additional donations to the
Children’s Wish Foundation.
-There WILL be a limited raffle for additional prizes.
-You do not have to ride to participate in this event, however because this is a fundraising event,
Remember,
this is
a Non-Profit
organization.
You MUST
register
to participate.
All Proceeds donated to the Children’s Wish Foundation
ROAD RULES
All Alberta highway laws apply. Participants MUST NOT drink and drive.
REGISTRATION INCLUDES
-Breakfast, Hot Dog Stop, Dinner, Entertainment
-Free Camping in Wayne (Sunday Breakfast Provided)
-Shuttle provided for those staying in Drumheller
FOR MORE INFORMATION, CALL
Canadian Oilfield Riders Association
5677 Burleigh Crescent SE Calgary, Alberta
(403) 255-3730
Randy Pedersen: 403-804-2170
Laurie Germsheid: 403-200-0333
Mike Thibault: 403-601-3690
Laurie Meyers:
Bill Karran:
Tim MacTavish: 403-860-0674
403-815-8380
403-852-6837
RIDER REGISTRATION / RELEASE FORM
If you would like to make a donation to the Children’s Wish Foundation (DIG DEEP… IT’S FOR THE KIDS!!),
please do so with a separate cheque and submit it with the attached donation form.
CANADIAN OILFIELD RIDERS ASSOCIATION – 27th ANNIVERSARY
Run for The Children’s Wish Foundation
SATURDAY, June 20TH, 2015
ENTRY FEE:
$75.00 FOR PRE-REGISTRATION (before May 30th to receive 27th Anniversary Pre-
registration Gift)
$75.00 IF YOU REGISTER AFTER May 30th (or on the day of the
event)
You do not have to ride to participate in this event, however because this is a fundraising
event,
You MUST register to participate.
For Pre-registration on line:
www.canadianoilfieldriders.ca
(PayPal available)
or you may fill in the form below & mail to:
Canadian Oilfield Riders Association
5677 Burleigh Crescent SE
Calgary, Alberta T2H 1Z7
Phone: (403) 255-3730
A separate registration form must be filled out and a separate fee for both rider and passenger
-- PLEASE PRINT CLEARLY –
NAME: __________________________________________________
DATE:_____________________________
ADDRESS: ______________________________________________
CITY: ______________________________
PROV / STATE:___________________________________
POSTAL / ZIP CODE: ______________________
HOME PHONE: _________________________________
BUS PHONE: _____________________________
Email Address: _____________________________________________________________________________________
EMERGENCY CONTACT: ________________________________
PHONE: ___________________________
I hereby represent and certify that I am over the legal age of 18 years and the information I have given is true and correct. I recognize and understand that the Canadian Oilfield Riders, and the Children’s Wish Foundation of
Alberta and the Co-Sponsors or their representatives (all being collectively referred to hereafter as “released parties”) are relying upon the accuracy of the information I am providing in allowing myself to participate in the above
listed charity ride.
I hereby state that I am experienced in and familiar with the operation of motorcycles and fully understand the risks and dangers inherent in motorcycling. I am voluntarily participating in the charity ride and I expressly agree to
assume the entire risk of any accident or personal injury, including death that I might suffer as a result of my participation in the charity ride. I participate in the ride knowing the existing weather conditions, road conditions and
other similar conditions and factors associated with this ride could be hazardous.
For and in consideration for the opportunity to engage in the ride for charity, I (on my own behalf and on behalf of my heirs, personal representatives, successors and assigns) do hereby release and forever discharge the
released parties (including their officers, directors, employees, agents and insurers) from any and all claims, demands, rights and causes of actions of any kind whatsoever which I now have, or later may have, known or
unknown, in any way resulting from or arising out of, my participation in this ride.
This release extends to any and all claims that I have or may have against the released parties whether such claims result from strict liability or negligence on the part of any of all of the released parties with respect to the design,
manufacture, repair or maintenance of the motorcycle(s) which I will be riding during the charity ride, or with respect to the conditions, qualifications, instructions, rules or procedures under which the ride is conducted or from any
other cause. However, I do not release any released party from any intentional misconduct on their part.
BY SIGNING THIS RELEASE, I CERTIFY THAT I HAVE READ THIS RELEASE AND FULLY UNDERSTAND IT, AND THAT I AM NOT RELYING ON ANY STATEMENTS OR REPRESENTATIVES OF ANYONE RELEASED
THEREBY.
I have made my CHEQUE PAYABLE TO “CANADIAN OILFIELD RIDERS ASSOCIATION”. I will conform to all rules and regulations of the Canadian Oilfield Riders Charity Run. I WILL NOT OPERATE A MOTOR VEHICLE
WHILE UNDER THE INFLUENCE OF ALCOHOL OR ANY OTHER ILLEGAL DRUG OR CONTROLLED SUBSTANCE.
Signature: ________________________________________________________ (must be signed to participate)
Cash: ______
Cheque: _____ # __________
Rider Band # ___________________________
RIDER REGISTRATION / RELEASE FORM
If you would like to make a donation to the Children’s Wish Foundation (DIG DEEP… IT’S FOR THE KIDS!!),
please do so with a separate cheque and submit it with the attached donation form.
CANADIAN OILFIELD RIDERS ASSOCIATION – 27th ANNIVERSARY
Run for The Children’s Wish Foundation
SATURDAY, June 20TH, 2015
ENTRY FEE:
$75.00 FOR PRE-REGISTRATION (before May 30th to receive 27th Anniversary Preregistration Gift)
$75.00 IF YOU REGISTER AFTER May 30th (or on the day of the event)
You do not have to ride to participate in this event, however because this is a fundraising
event,
You MUST register to participate.
For Pre-registration on line:
www.canadianoilfieldriders.ca
(PayPal available)
or you may fill in the form below & mail to:
Canadian Oilfield Riders Association
5677 Burleigh Crescent SE
Calgary, Alberta T2H 1Z7
Phone: (403) 255-3730
A separate registration form must be filled out and a separate fee for both rider and passenger
-- PLEASE PRINT CLEARLY –
NAME: __________________________________________________
DATE:_____________________________
ADDRESS: ______________________________________________
CITY: ______________________________
PROV / STATE:___________________________________
POSTAL / ZIP CODE: ______________________
HOME PHONE: _________________________________
BUS PHONE: _____________________________
Email Address: _____________________________________________________________________________________
EMERGENCY CONTACT: ________________________________
PHONE: ___________________________
I hereby represent and certify that I am over the legal age of 18 years and the information I have given is true and correct. I recognize and understand that the Canadian Oilfield Riders, and the Children’s Wish Foundation of
Alberta and the Co-Sponsors or their representatives (all being collectively referred to hereafter as “released parties”) are relying upon the accuracy of the information I am providing in allowing myself to participate in the above
listed charity ride.
I hereby state that I am experienced in and familiar with the operation of motorcycles and fully understand the risks and dangers inherent in motorcycling. I am voluntarily participating in the charity ride and I expressly agree to
assume the entire risk of any accident or personal injury, including death that I might suffer as a result of my participation in the charity ride. I participate in the ride knowing the existing weather conditions, road conditions and
other similar conditions and factors associated with this ride could be hazardous.
For and in consideration for the opportunity to engage in the ride for charity, I (on my own behalf and on behalf of my heirs, personal representatives, successors and assigns) do hereby release and forever discharge the
released parties (including their officers, directors, employees, agents and insurers) from any and all claims, demands, rights and causes of actions of any kind whatsoever which I now have, or later may have, known or
unknown, in any way resulting from or arising out of, my participation in this ride.
This release extends to any and all claims that I have or may have against the released parties whether such claims result from strict liability or negligence on the part of any of all of the released parties with respect to the design,
manufacture, repair or maintenance of the motorcycle(s) which I will be riding during the charity ride, or with respect to the conditions, qualifications, instructions, rules or procedures under which the ride is conducted or from any
other cause. However, I do not release any released party from any intentional misconduct on their part.
BY SIGNING THIS RELEASE, I CERTIFY THAT I HAVE READ THIS RELEASE AND FULLY UNDERSTAND IT, AND THAT I AM NOT RELYING ON ANY STATEMENTS OR REPRESENTATIVES OF ANYONE RELEASED
THEREBY.
I have made my CHEQUE PAYABLE TO “CANADIAN OILFIELD RIDERS ASSOCIATION”. I will conform to all rules and regulations of the Canadian Oilfield Riders Charity Run. I WILL NOT OPERATE A MOTOR VEHICLE
WHILE UNDER THE INFLUENCE OF ALCOHOL OR ANY OTHER ILLEGAL DRUG OR CONTROLLED SUBSTANCE.
Signature: ________________________________________________________ (must be signed to participate)
Cash: ______
Cheque: _____ # __________
Rider Band # ___________________________
CHARITABLE DONATION FORM
You should fill this form out ONLY if you wish to make a donation to the Children’s Wish Foundation.
Entry for Participation in this event must be done separately by filling our the attached
Rider Registration / Release From,
CANADIAN OILFIELD RIDERS ASSOCIATION – 27th ANNIVERSARY
Run for The Children’s Wish Foundation
Weekend of June 20th, 2015
Proceeds raised from this event will be donated to the
CHILDREN’S WISH FOUNDATION OF ALBERTA
Please ensure that all donations are made payable to the “Children’s Wish Foundation of
Alberta”.
A tax deductible receipt will be forwarded to all donors by the Children’s Wish Foundation of Alberta.
Attach your donation to this form and return both to a Canadian Oilfield Riders Association Committee
representative or mail to:
Children’s Wish Foundation of Alberta
C/o Canadian Oilfield Riders Association
5677 Burleigh Crescent SE
Calgary, Alberta
T2H 1Z7
Attention: Larry Pedersen (255-3730)
LEVEL OF DONATION YOU ARE MAKING (PLEASE CHECK THE APPROPRIATE BOX)
Roughneck - $50.00
Motorman - $100.00
Derrickman - $250.00
Driller - $500.00
Toolpush – over $500.00
-- PLEASE PRINT CLEARLY –
Send my tax receipt for $______________
NAME: _________________________________________
ADDRESS: ______________________________________________
CITY: ______________________________
PROV / STATE: ___________________________________
POSTAL / ZIP CODE: _______________________
Email: ___________________________________________
HOME PHONE: _________________________________
SIGNATURE: ___________________________________
BUS PHONE: _____________________________