16th Annual LBI Unithon

Saturday,June 7th, 2014

Long Beach Island, New Jersey

 

To Benefit the Alliance for a Living Ocean

 

Entry Fee is $30 (includes a Unithon T-shirt). Please make checks payable to ALO and send entry fee and signed waiver to:

 

Raphael Lasar

54 Oak Knoll Drive

Matawan, NJ 07747

 

Name___________________________________________

 

Address_________________________________________

 

City and State____________________________________  Zip Code______________

 

Phone______________________________ Email_______________________________

 

T-Shirt Size:____________________________________ (Those who pre-register will be given preference)

As a condition of entry and participation in the Unithon, the rider assumes all risk of personal injury, death or property loss resulting from any cause whatsoever. The rider agrees that the Alliance for a Living Ocean and the event organizers shall not be liable for any such personal injury, death or property loss and releases the ALO and the event organizers and waives all claim with respect thereto.

 

Signed_____________________________________Dated_______________________

Parent/Guardian Signature (for minor rider)_____________________________________Dated_______________________