Biking Across Kansas Online Registration

If you prefer to pay by check, please fill out the form below, print it out and mail it along with payment to:
Biking Across Kansas, PO Box 192, Olathe, KS 66051
Checks payable to: Biking Across Kansas

Our secure online registration system accepts Visa, Mastercard and Discover.

Your web browser preferences must be set to accept cookies in order for your registration to proceed.

Your child will be participating
on BAK as:

Description of entry types

Vegetarian or Vegan diet?:

No Vegan Vegetarian
Select your diet preference.

Your child is:

Male Female

Age (as of 6/9/2017) Date of Birth MM/DD/YYYY

First Name:

Last Name:

Address:

City:

State

Zip:

Country

Email:

Home Phone:

Cell Phone:

Please enter the name of your child's guardian during BAK:

(Authorized guardians must be 25 years or older
and be a registered participant on BAK 2017)

Emergency Contact Name:

Emergency Contact Address:

Emergency Contact Phone:

Additional Comments:
(please list any existing medical conditions that BAK organizers and medics should know about)


	You must read and agree to the release to continue the registration process. Open printable version of the release	BIKING ACROSS KANSAS, INC. Biking Across Kansas 2017 ("Event") I understand that bicycling in the Event has risks of injury and damage. With that understanding, and in consideration of my being allowed to participate in the Event sponsored by Biking Across Kansas, Inc., I agree to the following: RELEASE: I hereby release and agree to hold harmless Biking Across Kansas, Inc., its organizers, officers, directors, members, employees, agents and volunteers (collectively "BAK"); schools providing accommodations for the Event and their personnel; and other bicycle riders participating in the Event, from any and all claims for personal injury, death or property damage resulting from the negligent acts or omissions of BAK; schools providing accommodations for the Event and their personnel; or other riders, sustained by me during my participation in the Event, and agree to indemnify BAK or any one or more of them for any expense or loss they may incur by reason of any such claim I may make. USE OF NAME/LIKENESS: I authorize and consent to persons acting for, volunteering, employed or contracted by Biking Across Kansas, Inc., whether by videotape, film, newsprint, website, Facebook, Twitter, written advertisement, or otherwise, to use or publish any materials containing my name or picture, and I release any sponsors and all persons acting under their authority from any claims I might have due to initial or subsequent publication of any such materials or photographs. I acknowledge that if my photo or name is used in such materials I will not be receiving any compensation whatsoever. I (the previously-named registrant/participant on the Biking Across Kansas 2017 Registration form) have read the above release and use of name/likeness agreement and voluntarily agree to accept its terms. Everyone under eighteen (18) years of age must have the following completed: PARENT/GUARDIAN RELEASE: I as parent or guardian of the above named minor hereby give my permission and consent voluntarily and freely for my child to participate in the Event. I further agree individually and on behalf of my child to the above terms and have fully read the "Release" and "Use of Name/Likeness." TO WHOM IT MAY CONCERN: We the undersigned, father, mother, or guardian, of the Event registrant have the legal custody and control of the Event registrant. Authorization is hereby given for medical care and treatment to be administered to our minor child in the event of serious injury or illness. This Consent and Authorization will be for the period from June 4-11, 2017. I Agree to the Terms of This Release