Rider's Cellphone * Rider's Tee Shirt Size * Please choose a size Small Medium Large X-Large XX-Large XXX-Large In case of a medical emergency, who can we contact? * Emergency Contact Address * Emergency Contact Cellphone Are you riding as a group or representing a First Responder Agency? If you are, please provide us with the name of your group or First Responder Agency's name. You may choose to ride in our established routes, or you may choose to ride in your own memorial route please and meet us at a predetermined location. If you choose to ride in our established routes, please use the drop-down boxes to choose which route(s) you would like to ride in. Northern Arizona Memorial Run September 24, 2022 (Please select from the options below) * Please choose only one option N/A Arizona Pioneers Cemetery Run Kingman Run Pinetop/Lakeside Run Prescott Run Other Agency Route Southern Arizona Memorial Run October 15, 2022 (Please select from the options below) * Please choose only one option N/A Tucson Metro Run Tucson/Nogales/Texas Canyon Run Yuma Run Other Agency Route Central Arizona Run November 12, 2022 (Please select from the options below) * Please choose only one option N/A Mesa/Sacaton Run Mesa/State Route 87 (Beeline Highway) Run Prescott/Yarnell/Anthem Run Other Agency Route WAIVER and RELEASE OF LIABILITY: I know that participating in a motorcycle ride is a potentially hazardous activity. I/We should not enter unless I/We am medically able and properly trained. I/We assume all risks associated with participating in this event including, but not limited to: falls, contact with other participants, the effects of the weather and traffic, all such risks being known and anticipated by me. Having read this waiver and knowing these facts and in consideration of your accepting my entry to participate in the ARIZONA FIRST RESPONDER MEMORIAL CHARITY MOTORCYCLE RIDE (herein after the “Event”) to be held on September 24, 2022, October 15, 2022 and November 12, 2022, in various locations throughout Arizona, I/We, intending to be legally bound, do hereby for myself, my heirs, my executors and administrators agree as follows: I/We do waive and forever release any and all rights and claims for any damages and liabilities of any kind arising out of my participation in the Event against all persons, entities and agencies involved with promoting and holding the Event, including but not limited to the coordinators of the Event, the Arizona Fallen Hero Memorial Riders (AZFHMR®) and the 100 Club Arizona, their sponsors, volunteers and vendors of the event, their agents, successors, representatives and assigns even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I/We assume the risk of all bodily injuries, including death, resulting there from, and personal injuries to me and damage to and loss of my property, including loss of use thereof and any other indirect or consequential damages, resulting directly or indirectly, wholly or in part, from my participation in the Event and while traveling to and from the Event. I/We also understand, while riding in the Event, any careless act on my part and/or failure to follow the rules of the event will result in my immediate disqualification to participate in the Event. I/We hereby agree, for myself and/or for a minor under the age of eighteen for whom I/We am/are signing, to indemnify, defend, and hold the entities named above harmless from and against any and all claims, liabilities, losses and damages, costs, expenses (including attorney’s fees) judgments and penalties arising out of any of my, and/or said minors, acts, or omissions to act. I/We understand that the Event reserves the right to use any and all participant’s names and/or likeness with regard to promotional and/or advertising materials. PLEASE TYPE YOUR FULL LEGAL NAMES BELOW * By checking the box, you certify that you are at 18 years of age or older and that you have read, fully understand the terms of this agreement. You are aware that this is a release of liability, a contract and sign it of your own free will. * RIDER RULES AGREEMENT (Please carefully read before checking the box) Everyone must submit a completed registration/signed waiver/signed ride rules and agreement forms and entrance fees prior to participating in the Event. The ride(s) you are registering to participate in is exclusively dedicated to honoring Arizona First Responders who lost their lives during the performance of their duties. We want the attention focused on those fallen heroes and their families. Thus, we respectfully request all participants, remain respectful to all other participants during any per-ride, post-ride, or the actual ride and/or any other Event(s) functions and remember the reason for the ride(s). The “RIDE REGIONAL COORDINATORS”, “ROAD CAPTAINS” and “EVENT COORDINATORS” are there for your protection, please follow all of their directions. All rules are enforceable by any participant of the Event. Report any violation of the rules to a Ride Regional Coordinator, Road Captain and/or Event Coordinators immediately. Last minute registration and payment will be accepted the day before and the day of each Event(s). Locations of check-in, last minute registration and updated information will be posted on our website https://azfhmr.org/. Each ride will start at approximately 8:00 AM and will conclude at a pre-determined time and location. I/We understand that T-Shirts are not guaranteed to be available for registrations after August 1, 2022. All vehicles (motorcycles, cars, trucks) must be properly registered and insured. Drivers must be properly licensed. The use of alcohol or any substance that affects the ability to operate or control his/her vehicle or which may be considered hazardous to the health and safety of participants and spectators is strictly forbidden. Any participant found to be in violation of this rule will be immediately removed from the Event. All State and Local traffic laws will be observed. Uniformed police officers may be present during the ride(s) and will take enforcement action on all observed violations of State and Local traffic laws. NO stunt riding or other negligent or reckless conduct of any kind will not be tolerated. Any participant found to be in violation of this rule will be asked to immediately leave the Event. In order to provide room for maneuverability, we will ride in a staggered formation. Please try not to bunch up or ride side-by-side. We will use a single line spread out formation for narrow roads. If you must leave the line, do so in an open safe area. If for any reason you must leave the ride, please alert the Regional Coordinator and/or Road Captain in your area that you are safe and if you do or do not need assistance. In the event of an emergency, the Regional Coordinator and/or Road Captain will have contact information for proper individuals to assist. Once you leave the ride, you may only re-enter at the back of the pack. After paying the registration fees, if for any reason you are unable to participate or are asked to leave the Event, the registration fees are non-refundable. This is NOT a race or timed Event. BE SAFE! If you are riding or driving, observe all traffic laws and be a defensive, courteous motorist. HAVE FUN, enjoy the ride and camaraderie with the participants of the Event(s). You are riding for a great cause, and we are appreciative you being a part of it. PLEASE TYPE YOUR FULL LEGAL NAME BELOW. By checking the box, you agree to abide by the rules as set forth in this agreement. * We cannot guarantee tee shirts will be available for registrations received on the day of the event(s). * I understand my membership will be verified and if it cannot I will be required to pay the full amount prior to participating in the memorial runs. * In order to receive updated information regarding the AZFHMR memorial motorcycle runs and/or events, I understand I must agree to receive a newsletter from the AZFHMR. You may unsubscribe from the newsletter at any time.