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6th Annual C.U.R.B.

Bike Ride
“In Memory of Jim”
Saturday, August 8th, 2009
New York Ave. and W. Penn Street, 10:00AM , Rain or Shine
An approximate 15-mile bicycle ride, not race, around the City of Long Beach

C.U.R.B. Citizens United to Remove Barriers (C.U.R.B.) is a local, non-profit

organization that offers the physically challenged a chance to live a
life free of barriers. C.U.R.B. intends to educate community awareness
of the ongoing needs of the physically challenged.

DONATION: $15.00 per child (17 and under), $20.00 per adult check* or cash

*Please make all checks payable to “C.U.R.B.”

STARTING POINT: Start at the parking lot of Long Beach Catholic Regional School,
located in the center of W. Penn in between New York Ave. and
Grand Blvd.

T-SHIRTS T-shirts will be distributed the day of the ride up until the start.
(All pre-registrants are guaranteed a t-shirt)**


46 Wisconsin Street
Long Beach, NY 11561

**-All entries must be mailed by Saturday, July 25th, 2009.-

-If not mailed by that date, you are able to register the day of the ride.-
-Sponsorships are also available-
C.U.R.B. BIKE RIDE 2009 (Registration)
In Consideration of your accepting this entry, I, the undersigned, intending to be legally bound, hereby, for myself, my
heirs, executors and administrators, waive and release any and all rights and claims for damages I may have against
the C.U.R.B. Organization, their representatives, successors, and assigns for any and all injuries suffered by me in
this event. I attest and verify that I am physically fit and have sufficiently trained for the completion of this ride and my
physical condition has been verified by a licensed medical doctor.

Registration – Please PRINT clearly

Name ____________________________________ Phone ______________________

Street City State Zip

Signature _______________________________Parent Signature____________________

If under the age of 17
Age __________ T-Shirt size S M L XL Male______ Female ______

 Check this box if you would like information on the next ride. E-mail ____________________

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