fall 2020 katy trail poker run

ride to eradicate polio from the world

PEDAL
FOR
POLIOProofing
Purposes
collect cards
OCTOBER
2 0 2 0 11TH win prizes
best hand wins

Only
AUGUSTA TRAIL HEAD
8:00 am registration,
$30 PRE-REGISTER
$40 DAY OF RIDE / $15 AGES 5-10
includes breakfast lunch & medal
ride begins at 9:00 am join us for lunch only for $15

2020 SUPPORTERS

register online at : stcharlesrotary . com | rotary 2341 @gmail . com | 314.888.0119

 St. Charles Rotary Club
PEDAL FOR POLIO
Join this family friendly event in an effort to eradicate polio throughout the world.
Sunday, October 11, 2020
Registration at 8 a.m.
Ride begins at 9 a.m.
Players will ride from Augusta to Weldon Spring and back ~ 20 miles round trip.
Collect playing cards along the way to form the best poker hand and win prizes!
$30 Registration Fee includes light breakfast, poker play,
lunch after the ride, fun throughout and a medal.
Please make checks payable to “St. Charles Rotary Club” and mail
c/o Chris Goellner 301 S. Main Street, St. Charles, MO 63301.

Ride will go on - rain or shine

Proofing
Please submit one form per rider
Questions? call Chris at 314-775-5707.
Return form by September 26.

Rider Name
Purposes
Rider Address City State Zip

Only
Rider Home Phone Rider E-mail

In consideration for being allowed to participate in the ride, the participant agrees as follows:
ASSUMPTION OF RISK/RELEASE AND WAIVER OF LIABILITY:
Each individual participating in the bicycle ride (hereafter “participant”) hereby acknowledges he/she assumes the risk of
any injury to person or property arising from the ride. Each participant hereby waives, releases and covenants not to bring
any claim against St. Charles Rotary Club, Rotary International, State of Missouri, Department of Natural Resources and their
respective officers, agents, employees and volunteers (all collectively referred to herein as the “charities”) from any loss or
damage, and any claim or demands, on account of injury or death to the participant or injury to property of the participant,
whether caused by the negligence of charities or otherwise, arising from the participant’s participation in the ride, and that
this agreement shall be binding upon the participant and his/her heirs, next-of-kin, personal representatives, successors and
assigns.
OBEY ALL APPLICABLE LAWS:
Each participant hereby represents and agrees that he/she will obey all state, federal, county and municipal laws during the
ride and will wear all minimum safety apparel as required by state law during the ride.

Signature of Rider Date
[Parent or legal guardian must sign on behalf of any rider under 18 years of age. If the parent or legal guardian is not present
on the ride date, the parent or legal guardian’s signature agreeing to the foregoing provisions must be notarized on this form].