2019
June 3rd-8th
Lake George, NY
Pre-registration Classic, Premium & Platinum Includes: • A chance to win over $60,000 in prizes • Grand Prize: 2019 Indian Scout Sixty Motorcycle! ¾¾ Please print clearly & sign waiver (passenger, too!) ¾¾ Complete one Registration Form per motorcycle. ¾¾ Additional Pre-Reg Forms available at Americade.com ¾¾ Photocopies & Faxes accepted: Update the contact info. Rider Name
¾¾ Or, Pre-register ONLINE at www.Americade.com ¾¾ Pre-registration Deadline: envelopes postmarked by May 1. After that date, post-register at Fort William Henry (June 3-8). Post-entry prices are higher, availability limited. ¾¾ Groups: To be scheduled together, registrations must be mailed in the same envelope or, done same day online.
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oBike oTrike oAuto
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Regis Marc ter before h t Early 15 h for Draw Bird ing
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Passenger Name(s)
Zip
How did you hear of Americade?
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Please provide your email address: ____________________________________________
PAYMENT OPTIONS: TOTAL FROM OTHER SIDE: $ _________ CREDIT CARD CHECK OR MONEY ORDER: GIFT CERTIFICATE Payable to Americade (Returned check charge: $40)
Fill out info below
Credit Card Info:
Mastercard
Visa
Discover
Put 16 digits (don’t forget the last 4)
Your Name:_________________________________________________________ (As it appears on the card) RELEASE AND INDEMNITY AGREEMENT
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Include GC with Pre-registration Form
Expiration Date
CVV2 #
Month
Must Provide
Year
(3 digit code on back of card)
MUST BE SIGNED FOR REGISTRATION TO BE PROCESSED
I hereby give up all my rights to sue or make any claim for damages due to negligence or any other reason whatsoever against the American Motorcyclist Association and its district organizations, Americade, Inc., Fort William Henry, Charles Wood Park, Lake George Village as pertains to minitour use of Beach Rd. Pk Lot only, Town of Lake George, NY State Dept. of Environmental Conservation, County of Warren, sponsors and all other persons, participants or organizations conducting business with, or connected with, this event for any injury to property or person I may suffer, including but not limited to crippling injury or death, while participating in the event, or while I am upon the event premises. I know the risks of danger to myself and my property while preparing for and participating in the event and while on the event premises, and relying upon my own judgment and ability, assume all such risks of loss, and hereby agree to reimburse all costs to those persons or organizations connected with this event for damages incurred as a result of my negligence. Rider: My motorcycle meets NY State noise and registration requirements & I have a valid motorcycle license or permit. I am 18 or older. o My passenger, if any, is 18 or older. o If not, make an “X” in this box o and have a legal guardian sign below. Rider Name (Print) ________________________________________
Passenger Name (Print) ___________________________________
Rider Signature _________________________________ Date _____
Passenger Signature ___________________________ Date ______
Under 18 Person’s Name (Print) ______________________________ Guardian Name (Print) ______________________________________ Age _________
Guardian Signature ______________________________ Date _____
¬¬Avoid Duplications: If you are re-sending a registration, please mark “duplicate” to avoid double charges. ¬¬Schedule Confirmations: will be mailed First Class within a month of registering. ¬¬Changes: Accepted in writing only and must be received by May 1. ¬¬Cancellations/Refunds (in writing only): Full refund less $35 if submitted more than 10 days before the event’s start. No refunds will be issued if submitted 10 days or less before start of event, unless cancellation is due to a medical emergency (must have medical documentation). All refunds will be issued by July 31st.
Please mail to: Americade PO Box 2205R | Glens Falls, NY | 12801 | USA 518-798-7888 | FAX: 518-798-0169