REGISTRATION FORM
Print from this site, or e-mail us for a copy to be sent to you.
Contact: gvalley.bike@sympatico.ca
Complete the registration form and mail it to:
Green Valley Bicycle Adventures
27B Riverside Drive East, Elmira, Ontario N3B 2L9
Phone:  519-669-9067  Fax:  519-669-3124
Please ensure that you have included your Payment and Signed Waiver.

Name ______________________________________    Age _____  Gender:  M___ F___

Address_________________________________________________________________

City/Town_______________________Province/State______________Country_________
Postal Code/Zip Code________________

Phone - Home (      ) __________________________ Business (     )__________________

Fax or E-mail address_______________________________________________________

Tour name____________________________Guide Hours $20 X_______ Date________________________
                                                                        (minimum Guide service is 2 hours or $40)
Do you bicycle   ____ once a week? ____ once a month?   ____ once a year?(Please check one)

Payment
Full payment is required for all tours.  All tour prices are shown in Canadian dollars.  VISA, Travellers Cheques, cash or personal cheques payable to  GREEN VALLEY BICYCLE ADVENTURES.
Confirmation will be sent upon receipt of registration and payment.
Visa # ______________________________________CardholderName____________________________
Expiry Date ________     Amount $_________CDN
Cancellation Policy
For cancellations 14 days to 3 days prior to tour date, there is a penalty of 15% of total guide cost.
 48 hours or less, there is a penalty of 100% of total guide cost.
GVBA reserves the right to cancel a tour.  In this case, payments will be fully refundable, or you can select a future date.
ALL PARTICIPANTS WILL HAVE THEIR OWN BICYCLE IN GOOD WORKING CONDITION,
AND WEAR AN APPROVED PROPER FITTING HELMET.
WAIVER
I acknowledge that I am aware of  risks to my person and to my property by accident, injury or otherwise in participating in this tour.  I hereby release Green Valley Bicycle Adventures, its employees, representatives and agents from any liability whatsoever arising from my participation in this tour.  I hereby hold harmless Green Valley Bicycle Adventures from any liability if I sustain any injury while in the care of any third party.  It is my responsibility to make sure that I have adequate medical coverage and I will assume all costs incurred for emergency services.
 
Signature__________________________________________    __________________________________     ________
                                                                                                                       Please print your name.                                Date
Please ensure that each rider in your group submits a completed registration form.
Please advise any medical conditions and allergies ________________________________________________________
In case of emergency, please contact:
Name_______________________________________    Phone (    )___________________ Relationship_____________
How did you learn about Green Valley Bicycle Adventures?(Please check one)advertisement  ________
website _______ brochure  ________  friend   ________ other __________
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