Elmhurst Bicycle Club Sign-In Sheet


Activity Name:_______________________________________

Elmhurst Bicycle Club Release and Liability Waiver

For liability protection and insurance purposes, it is the policy of the Elmhurst Bicycle Club ("EBC") to require all of its members to sign the Release and Liability Waiver which is a part of the EBC Membership Application. Guests of the EBC (which term includes all non-members of EBC) who wish to participate in any EBC activity must sign the equivalent release and liability waiver contained on the EBC Sign-in Sheet before the activity starts. Any guest refusing to sign the release and liability waiver may not participate in the activity. Should the activity continue, however, with the participation of the non-signing guest, the activity will no longer be considered to be an EBC sponsored or sanctioned activity.

Members: PRINT Your Name and ICE number below      Guests: COMPLETE your information on the reverse side.
Please provide a phone number to call in case of an emergency (ICE#) or confirm that you are wearing a RoadID.


  Name ICE# or
Road ID Yes
  Name ICE# or
Road ID Yes
1     13    
2     14    
3     15    
4     16    
5     17    
6     18    
7     19    
8     20    
9     21    
10     22    
11     23    
12     24    

Event Leader:  Scan and e-mail to:  MemberMiles@ElmhurstBicycling.org within 3 weeks of the event.
Note: Only one (1) event per Sign-In Sheet.