This form MUST be signed by every registrant in order to participate. Anyone under the age of 18 interested in participating must have this document signed by a parent or legal guardian.

I attest and verify that I am physically fit for this event, and I hereby release the non-profit 'Brandon A. Storey Foundation',its officers, sponsors, organizers, volunteers, Wisconsin State Fair Park, Milwaukee County, and the City of West Allis, for any and all injuries or damages of any kind whatsoever suffered as a result of taking part in the event and any related activities.

PARENT SIGNATURE: _______________________________
DATE: ________________

Once completed please bring this signed form to the BAS Ride/Walk '99 on September 27th when you check in before the ride.