Cabin 5 Registration – Bikers Weekend

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Start Date:

End Date:

Name^*

Address^*

Phone^*

Email^*

I and my motorcycle can physically travel approximately 250 kms without needing to stop for breaks or fuel^*

Yes No

If No, how far can you or your motorcycle travel before needing a break or to refuel?^*

I will join the group on September 5, fueled up at:^*

5:45 AM SHARP – Departure from Waterloo (Tim’s at Northfield Dr. and Davenport) 8:00 AM – Stayner Camp, 240 Scott St. Stayner, ON (Breakfast) 9:15 AM – Departure from Stayner for Mishewah 3:15-5:00 PM – Camp Mishewah, 4422 Round Lake Rd., Killaloe, ON (Supper at 5:30 pm, included in weekend fee)

Do you have any food allergies?^*

Yes No

Please describe your food allergies^*

Waiver
I understand and am aware that there are dangers and risks involved in riding a motorcycle, and in riding a motorcycle in a group such as the Mishewah Bikers’ Weekend.

These dangers and risks include damage, injury, serious injury and/or death. Knowing and appreciating fully these dangers and risks,

I the undersigned, hereby waive, release, and forever discharge Evergreen Christian Ministries, the proceed recipient, the members of the organizing committee, sponsors, volunteers, and all other associates with the event of and from all manner of actions, causes of action, suits, debts, claims and demands whatsoever arising from or in connection with the Mishewah Bikers’ Weekend.

I assume full responsibility for injury or damage arising as a result of my participation with the Mishewah Bikers’ Weekend event and for my passengers.

This waiver also includes a 'model release' for photographs taken and audio/video recordings made while participating in this weekend of activities.

I consent to being added to ECM's email list^*

Yes No

If you are not already receiving them, may we add you to our mailing list to receive occasional news and updates from Camp Mishewah and ECM Camps?

Total Cost

Please select a date first.

Payment Method^*

Pay Online (Credit/Debit)

Pay with your credit or debit card online.

Phone: 1-833-ECM-CAMP (1-833-326-2267)

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Cabin 5 - Bikers Weekend

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